Agenda Document Pack - Integration Joint Board - 12/02/2026
North Ayrshire Council · 12 February 2026
Back to Integration Joint Board — 12 February 2026 and its agenda
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Integration Joint Board Meeting Thursday, 12 February 2026 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 11 December 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 Review of Decision relating to Island Communities Impact Assessment for Montrose House Care Home on Arran Submit report by the Head of Service (Democratic Services) on the review of the Island Communities Impact Assessment (ICIA) relating to the decision of 21 August 2025 in respect of provision at Montrose Care Home, Arran (copy enclosed). 5 Director's Report Submit report by Caroline Cameron, Director (NAHSCP), on developments within the North Ayrshire Health and Social Care Partnership (copy enclosed). 6 Alcohol & Drug Partnership Strategy 2025-2028 Submit report by Michael McLennan, ADP Lead Officer, on the Alcohol & Drug Partnership Strategy 2025-28 (copy enclosed). 1
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7 Participation and Engagement Strategy 2026-2030 Submit report by Caroline Cameron, Director (NAHSCP) on the updated Participation and Engagement Strategy for 2026-2030 (copy enclosed). 8 2025-26 – Month 9 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 9 (December) (copy enclosed). 9 Fees and Charges 2026-27 - Social Care Services Submit report by Eleanor Currie, Chief Finance Officer and Section 95 Officer, on the proposed charges for provided adult social care services for 2026/27 (copy enclosed). 10 Whistleblowing Quarter 2 Report: 1 July – 30 September 2025 Submit report for information in relation to whistleblowing concerns raised in Quarter 2 (1 July – 30 September 2025) (copy enclosed). 11 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, 2
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substantial damage or distress to any individual, please contact dataprotectionofficer@north-ayrshire.gov.uk 3
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IJB Sederunt Voting Members Joyce White (Chair) NHS Ayrshire & Arran Cllr 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 Julie Barrett Associate Nurse Director Vacancy 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 Vacancy Service User Representative Vacancy Independent Sector Representative Vicki Yuill Third Sector Representative 4
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North Ayrshire Health and Social Care Partnership Minute of Integration Joint Board meeting held on Thursday 11 December 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 Anthea Dickson, North Ayrshire Council 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 Scott Hunter, Chief Social Work Officer Sharon Hackney, Lead Allied Health Professional Stakeholder Representative Lynda MacFarlane, Staff Representative Present (Remote Participation) Voting Members Councillor Chloe Robertson, North Ayrshire Council (Vice-Chair) Councillor Tom Marshall, North Ayrshire Council Tom Hopkins, NHS Ayrshire and Arran Linda Semple, NHS Ayrshire and Arran Stakeholder 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) Seony Ross, Team Manager (Strategic Planning & Equalities) Kerryanne Owens, Carers Development Officer Fraser Bedwell, CEO Unity Ruth Wilson, Team Leader (Litigation) Hayley Young, Senior Committee Services Officer Agenda Item 3 5
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John Hutcheson, Senior Communications Officer Apologies Councillor Nairn Angus-McDonald, North Ayrshire Council Darren Fullarton, Associate Nurse Director/ Lead Nurse Lisa Davidson, Public Health Representative Wendy Van Riet, Director of Psychological Services Lorna Sim, Staff Representative NHS Ayrshire and Arran Aileen Craig, IJB Monitoring Officer 1. Apologies for Absence Apologies for Absence were noted. 2. Declarations of Interest There were no declarations of interest in terms of Standing Order 7.2 and Section 5.14 of the Code of Conduct for Members of Devolved Public Bodies. 3. Minutes The accuracy of the Minutes of the meeting held on 13 November 2025 were confirmed and the Minutes signed in accordance with Paragraph 7(10 of Schedule 7 of the Local Government (Scotland) Act 1973. 4. Director’s Report Submitted report by Caroline Cameron, Director (NAHSCP) on the developments within the North Ayrshire Health and Social Care Partnership. Noted. 5. Unpaid Carers Strategy & Delivery Plan Submitted a report by Scott Hunter, Chief Social Work Officer (NAHSCP) on the Unpaid Carers Strategy & Delivery Plan set out at Appendix 1 to the report. The report details the progress of the 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. Officers responded to members’ questions on various aspects of the report. The Board agreed to endorse the ‘Together We Care’ Carers Strategy 2026-2029. 6. Refreshed Strategic Plan 2026-2030 Submitted a report by Caroline Cameron, Director (NAHSCP), on the refreshed Strategic Plan for 2026-2030. The proposed Strategic Plan replaced the current priorities of the Caring Together 2022-2030 - Enable Communities, Develop and Support our Workforce, Provide Early and Effective Support, Improve Mental and Physical Health and Wellbeing, and Tackle Inequalities. It proposed 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. 6
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Officers responded to members’ questions on various aspects of the report. The Board agreed to approve the refreshed Strategic Plan, to cover the remainder of the Caring Together period, from 2026-2030. 7. 2025-26 – Month 7 Financial Performance Submitted report by Eleanor Currie, Chief Finance Officer and Section 95 Officer (HSCP) on the Integration Joint Board’s financial performance as at Month 7 (October). 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 £4.947m reducing to £1.881m after planned recovery actions; (b) note the progress with delivery of agreed savings; (c) approve the proposed and current actions (para 2.14) being taken to progress financial recovery and that an updated recovery plan will be presented to the next IJB; (d) note the remaining financial risks for 2025-26; and (e) request the Chief Officer write to the Cabinet Secretary to request additional funding to continue to address the funding needs in North Ayrshire. 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 and the preparation of the detailed budget for 2026-27 that will be brought to the March 2026 meeting for approval. The Medium-Term Financial Outlook (MTFO) covered the three-year period 2026- 2029 and looked at the range of factors that influence the financial planning of the Integration Joint Board. A range of possible scenarios for the financial position in each year were considered based on the information currently available which helped 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. Officers responded to members’ questions on various aspects of the report. Noted. The meeting ended at 11.45 a.m. The full meeting proceedings can be viewed at https://north-ayrshire.public-i.tv/core/portal/home 7
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Integration Joint Board 12th February 2026 Subject : Review of Decision relating to Island Communities Impact Assessment for Montrose House Care Home on Arran Purpose : To seek Integration Joint Board’s determination of the review of the Island Communities Impact Assessment (ICIA) relating to the decision of 21 August 2025 in respect of provision at Montrose Care Home, Arran. Recommendation : IJB are asked to decide whether: (a) Further information is required to enable a decision to be made on the review, and, if so, what information is needed and from whom; or (b) The ICIA appended to the IJB report of 21st August 2025 was sufficient, and no further action is required; or (c) Changes are needed to the ICIA; or (d) A new ICIA requires to be carried out. Thereafter that any relevant statutory notice to reflect the decision of IJB is issued within the appropriate timescales. 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 ICIA Islands Communities Impact Assessment 1. EXECUTIVE SUMMARY 1.1 On 11 November 2025, the North Ayrshire Integration Joint Board (“IJB”) received an application for a review of a decision relating to an island communities impact assessment (“ICIA”) carried out in respect of Montrose House. A copy of the ICIA is attached at Appendix 1. 1.2 The review application relates to the Integration Joint Board’s decision of 21 August 2025 to redesign the model of care at Montrose House, which included a permanent reduction in bed capacity. Agenda Item 4 9
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This process is not a mechanism to review the substantive decision or for the IJB to reexamine the entirety of the issues that formed part of its decision, but a review of relevant issues relating to the ICIA only, in accordance with this report. 1.3 The review is made on one of the four statutory grounds provided for in the Island Communities Impact Assessments (Publication and Review of Decisions) (Scotland) Regulations 2020 (the “2020 Regulations”), specifically alleging that the IJB, in making its decision: failed in its duty under section 8(3)(b) of the Islands (Scotland) Act 2018 (the “2018 Act”) to assess the extent to which the IJB [considered] that the service [could] be developed or delivered in such a manner as to improve or mitigate, for island communities, the outcomes resulting from it (Regulation 4(c) of the 2020 Regulations). Essentially, this ground of review relates to whether the ICIA contained an adequate assessment as to improvements or mitigations that might offset the impact on the island community, in respect of the proposals regarding Montrose House. That is the issue that the IJB must now consider and decide upon through this review process. A redacted copy of the review form is included in full at Appendix 2. Within that, the applicant has stated that the decision did not take into account the requirements of Arran residents, there was inadequate discussion with residents and no time allowed for any alternative proposals to be presented or discussed. 2. BACKGROUND 2.1 At the Integration Joint Board meeting in June 2025 the IJB asked officers to undertake further work on the proposals around the future provision of nursing care services within Montrose House Care Home, Arran, specifically in relation to the options appraisal, consultation, engagement and impact assessment, including consideration for islands impact. 2.2 On 21 August 2025 the IJB agreed to adopt and implement a revised service delivery model at Montrose House. The decision taken by the IJB on that date was on the following terms: (a) approve the outcome of the Montrose House options appraisal and the recommended option for future delivery in Montrose House of 10 permanent beds and 1 respite bed; (b) approve the recommended model of day care delivery for older people on the island of Arran; (c) support the principle of and development of an admissions policy for Montrose House to prioritise care for the residents of Arran and provide a robust admissions criteria; 10
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(d) note the further work undertaken over the summer period to engage and seek feedback on the proposed changes, the outputs of this engagement are shared within the report and options appraisal; and (e) agree to declare the remainder of the Montrose House building as surplus to North Ayrshire Council and work with NAC colleagues to identify alternative uses which complement the care home facility. Requirements of the Islands (Scotland) Act 2018 2.3 Under the Islands (Scotland) Act 2018 (the ”2018 Act”), the Integration Joint Board has a duty to prepare an island communities impact assessment (“ICIA”) in relation to a policy, strategy or service which, in the IJB’s opinion, is likely to have an effect on an island community which is significantly different from its effect on other communities (including other island communities) in North Ayrshire. Officers identified that an ICIA was required in relation to the likely impact of the proposals for a revised model of care at Montrose House. 2.4 A public consultation was carried out on the proposals between 15 July and 1 August 2025. Information regarding consultation responses is included in the ICIA at Appendix 1. 2.5 Under section 8(3)(b) of the 2018 Act, an ICIA must “assess the extent to which the authority considers that the policy, strategy or service (as the case may be) can be developed or delivered in such a manner as to improve or mitigate, for island communities, the outcomes resulting from it”. 2.6 The “island community” is defined in Section 2 of the 2018 Act as a community which - (a) consists of two or more individuals, all of whom permanently inhabit an island (whether or not the same island) and (b) is based on common interest, identity or geography (including in relation to any uninhabited island whose natural environment and terrestrial, marine and associated ecosystems contribute to the natural or cultural heritage or economy of an inhabited island. Application for Review 2.7 On 11 November 2025 the IJB formally received an application for a review of a decision relating to the ICIA carried out in respect of Montrose House. 2.8 The 2020 Regulations set out the possible grounds for a review of a decision relating to an ICIA. The 2020 Regulations also provide that an application for review of a decision relating to an ICIA should be made to the authority which made the decision. The application for review that is presently under consideration by the IJB is made on the ground that the applicant considers that the IJB, in making its decision, failed in its duty under section 8(3)(b) of the 2018 Act. The full text is set out in bold at paragraph 2.5 above. 11
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2.9 Redacted copies of all documentation relating to the review are available on the HSCP website in accordance with the legislative requirements under the 2020 Regulations. IJB members have been provided with unredacted copies of all documentation relating to the review. This report sets out the framework within which the IJB is being asked to make its decision and seeks to highlight relevant information for the IJB’s consideration. It does not include the entirety of the information that the IJB must consider. The IJB must consider all relevant information and submissions in making its determination on the review. Written Representations 2.10 A notice was published on the HSCP website as required under the 2020 Regulations, giving notice of the application for review and inviting members of the public to submit written representations within a defined period (as per the 2020 Regulations). 2.11 Between 12 November 2025 and the deadline of 3 December 2025, a total of 89 written representations were received in connection with the review of the ICIA. The representations received broadly expressed support for the review. Those who submitted written representations emphasised the reasons why they believe the policy will result in negative outcomes for the island community. Many also expressed concerns about the consultation that was carried out. A summary of the views expressed is included at Appendix 3. 2.12 The written representations were then sent to the applicant for their comment, as required under the 2020 Regulations. A redacted copy of all written representations is also available on the HSCP website to view. 2.13 At the closing date of 13 January 2026, no further comments were received by the applicant. Mitigations proposed by those who supported the review 2.14 Some of those who submitted written representations suggested measures which they felt would mitigate the impact of the proposal on the island community and which they felt had not been assessed. These are summarised below: 1. Addressing staffing shortages locally by: a. Engaging with local educators and training providers b. Exploring alternative ways of promoting vacancies locally c. Adapting shift patterns and working hours to suit the local workforce and align with ferry schedules d. Making further provision for full time or temporary accommodation of staff on the island to reduce the need for staff to commute from the mainland 2. Making only temporary changes in numbers to address safety concerns whilst enabling the longer-term impact to be reduced 3. Outsourcing the delivery of services at Montrose House to a delivery partner with broader experience in the sector. 12
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ICIA Mitigations 2.15 In reaching its decision, the IJB should also consider the position put forward by officers in August 2025 and specifically, the mitigations that were referenced in the ICIA (Appendix 1) including: 1. Accommodation and financial incentives having been offered to staff in order to address staffing challenges 2. Island Social Work teams offering support and relevant referrals to support with isolation 3. Day service review at Montrose House 4. Acknowledgement that there is no ability to mitigate the financial cost borne by family requiring to visit family in care homes on the mainland. Review Consideration 2.16 A hearing process will be followed at the IJB meeting to ensure a fair and transparent decision making process. The applicant has been invited to address the IJB. HSCP officers have similarly been invited to address the IJB. Review Decision 2.17 IJB is now asked to consider the application for review and decide whether or not the IJB discharged its duty to ensure that the ICIA for Montrose House assessed the extent to which the relevant proposals could have been developed or delivered in such a manner to improve or mitigate, for island communities, the outcomes resulting from it. 3. PROPOSALS 3.1 IJB is asked to make a decision on the review, choosing one of the following options: a) Further information is required to enable a decision to be made on the review, and, if so, what information is needed and from whom; or b) The ICIA appended to the 21 August 2025 IJB report was sufficient, and no further action is required; or c) Changes are needed to the ICIA; or d) A new ICIA requires to be carried out. 4. IMPLICATIONS 4.1 Financial None. 4.2 Human Resources None. 13
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4.3 Legal The IJB is under a legal duty to ensure that the relevant ICIA assessed the extent to which the proposal could be developed or delivered in such a manner as to improve or mitigate, for island communities, the outcomes resulting from it. The applicant has applied for a review of the decision under the statutory review process set out in the Islands (Scotland) Act 2018 and The Island Communities Impact Assessments (Publication and Review of Decisions) (Scotland) Regulations 2020. The IJB is required to make a decision in accordance with the terms of the 2020 Regulations, after due consideration of relevant matters. 4.4 Equality/Socio-Economic None. 4.5 Risk None 4.6 Community Wealth Building None 4.7 Key Priorities None 5. CONSULTATION The original decision taken by the IJB, which is the subject of the review application, was informed by a public consultation in 2025 across, citizens, community and stakeholder groups and staff. As part of the statutory review process, members of the public have had the opportunity to submit written representations in connection with the review. Aileen Craig Head of Service, Democratic Services Appendices • Appendix No 1 – ICIA Montrose House • Appendix No 2 – Application for Review • Appendix No 3 – Concerns raised in written representations about the impact of the policy on the island community and the method of consultation 14
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1 APPENDIX 1 - ISLAND COMMUNITIES IMPACT ASSESSMENT ISLE OF ARRAN Please ensure this template is completed in conjunction with the Island Communities Impact Assessment (ICIA) Guidance on the Scot Gov Website Name of Policy, Strategy or Service Montrose House - Arran STEP ONE – DEVELOP A CLEAR UNDERSTANDING OF YOUR OBJECTIVES What are the objectives of the policy, strategy or service? Montrose House Care home on the Isle of Arran is undertaking a review of the existing services due to the following: a) Older People Day Service – the traditional day service provision closed due to infection control requirements during the Covid 19 pandemic and has not re-opened. A service review, alongside stakeholder engagement, is taking place to identify a day service model which will best meet the needs of future service users, and their carers. Proposal to explore a hybrid day-case model, that will be provided in-house and community-based working alongside the activity coordinator b) Montrose House continues to face significant operational challenges related to staffing levels, due to the limited availability of social care trained staff on the island. As a result of these staffing challenges there has been a reliance on agency workers, to ensure safe staffing levels within the home. Unfortunately, at times agency staff cover can be irregular, which affects the continuity and quality of care delivery. As a result the Montrose House Care Home budget has been overspent over the last 2 financial years. There are currently 12 residents, and the option appraisal proposal recommends a reduction from 15 permanent beds to 10 permanent care beds and 1 respite bed. This will improve service resilience, safety and quality, by having a sustainable service with a staffing model which does not rely 15
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2 on agency staff. If achieved, this will result in improved safe care delivery and the overspend being reduced significantly. c) The review is also proposing the development of an admissions policy to prioritise those with familial ties on the island to access the Montrose House beds. 16
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3 Do you need to consult? The service review requires robust engagement, and this is captured at in section 3 of this report. The engagement will influence the proposals and identify key barriers for mitigation, where this is available. How are islands identified for the purpose of the policy, strategy or service? This policy would only apply to Montrose House Care home on the Isle of Arran What are the intended impacts / outcomes and how do these potentially differ in the islands? – EMPHASISE HOW IT DIFFERS FROM MAINLAND Montrose House on Arran is the only Health and Social Care Partnership managed care home and as a result this policy does not apply to the mainland or the Isle of Cumbrae, where care homes are delivered by the private independent sector. Is the policy, strategy or service new? Yes. Although the service at Montrose House is well established the following new changes are proposed: a) Older People Day Service – the traditional day service provision closed due to infection control requirements during the Covid 19 pandemic and has not re-opened. A service review, alongside stakeholder engagement, is taking place to identify a day service model which will best meet the needs of future service users, and their carers. Proposal to explore a hybrid day-case model, that will be provided in-house and community-based working alongside the activity coordinator b) Montrose House continues to face significant operational challenges related to staffing levels, due to the limited availability of social care trained staff on the island. As a result of these staffing challenges there has been a reliance on agency workers, to ensure safe staffing levels within the home. Unfortunately, at times agency staff cover can be irregular, which affects the continuity and quality of care delivery. As a result the Montrose House Care Home budget has been overspent over the last 2 financial years. There are currently 12 residents, and the option appraisal proposal recommends a reduction from 15 permanent beds to 10 permanent care beds and 1 respite bed. This will improve service resilience, safety and quality, by having a sustainable service with a staffing model which does not rely on agency staff. If achieved, this will result in improved safe care delivery and the overspend being reduced significantly. 17
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4 c) The review is also proposing the development of an admissions policy to prioritise those with familial ties on the island to access the Montrose House beds. STEP TWO – GATHER YOUR DATA AND IDENTIFY YOUR STAKEHOLDERS What data is available about the current situation in the islands? There has been the collection and analysis of a wide range of data sources: 1. Arran Locality Profile 2017 [http://northayrshire.community/wp- content/uploads/2018/02/Locality-Profile_Arran_Final_Version_Sept2017.pdf] 2. Arran Integrated Island Service Review - Initial Review 20th July 2020 [2020-08-17-bm- p24-arran-integrated-island-services-initial-agreement.pdf] 3. Isle of Arran – Local Island Plan March 2022 [https://www.north- ayrshire.gov.uk/Document-library/arran-local-island-plan.pdf] 4. Scottish Census 2022 [https://www.scotlandscensus.gov.uk/] 5. Health & Social Care Partnership – Integrated Island Services Management Information on workforce, workforce recruitment, financial, resident needs, etc. [internal – not for publication] Do you need to consult? Yes. Montrose House Engagement - Goals of Engagement The engagement will provide background information and awareness of the proposals a) older people day services b) Montrose house bed reduction and c) a new admissions policy. The proposals will highlight the positive changes, such as the re-introduction of hybrid day- case model, that will be provided in-house and community-based working alongside the 18
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5 activity coordinator. It will be helpful to get feedback on this approach, from community views of a workable model. The engagement will include reasons for the proposals, driven by critical staffing challenges and focussing on the difficulty in providing safe person-centred care. This will also highlight the financial pressures created due to the use of agency staff. The engagement event will provide an awareness of the admission processes/ waiting list for beds if assessed as suitable for Montrose House. What we want to achieve from engagement? Receiving feedback on the proposals; as well as providing reassurance and alleviate any concerns the community may have. This information will be fed back to the NAHSCP senior management team and will be included in the updated ECRIA and IJB report for submission in August 2025. Montrose House Engagement drop in Event was held within Montrose House by the Arran Senior Management team on 22nd July 2025 from 1000-1200. The audience was the public, residents, families, and visitors. The drop-in session will include: • public, residents, families, and visitors provided with a leaflet/flyer in Montrose House for the Questionnaire/Online Survey. Survey can be accessed by a QR code but paper copies available for completion at face-to-face sessions and uploaded later. • Prepared, clear concise answers to questions that might be raised to ensure that all staff participating in the event are collectively sharing the same information. The details of the drop-in were emailed to 16 community groups; the details of which were provided by the Arran Community Voluntary Organisation. These groups included Brodick and Lamlash Sheltered Housing complexes, Older People Groups, Lunch Clubs, Community Councils, and patient participation groups. Posters about the drop-in session were shared at Montrose House and GP surgeries. Service Users and Partner staff 19
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6 The Questionnaire/Online Survey using a QR code was available, from 15 July 2025 to 1st August 2025; with paper copies available too for completion. Members of the public were provided with support from variety of HSCP staff. 1. Care at Home & Alert service users - completion supported by Care at home staff. 2. District Nursing caseload patients-completion supported by District Nursing staff. 3. patient participation groups- support from primary care 4. Relevant community groups-Vicki Yuill ACVS providing contact details. 5. Support from engagement team required with preparation of survey/questionnaire, QR code and analysis/overview of results There were 458 responses to the Residents, Families and Wider Island Community survey ∗ The majority reported having a spouse (36%) and/or wider family (35%) living locally. 18% said they have children on the island, while 10% (48 respondents) indicated they have no family living on Arran ∗ The vast majority of respondents, 82.8% (403 people) do not currently receive support from health and social care services on the Isle of Arran ∗ 97% of respondents (444 individuals) were aware of the current recruitment challenges across various sectors of Isle of Arran, ∗ 97.6% (447) of recipients opposed the recent change in bed capacity at Montrose House. 1.5% (7) were in favour and 0.9% (4) were unsure if it was the correct move. ∗ 73.1% of respondents (“Definitely”: 37.3% and “Possibly”: 35.8%) would consider using an outreach day care service on Arran, while only 3.3% said No and 5.2% said Unlikely, with 18.3% Unsure. ∗ 32% (145 people) support the proposed admissions policy approach, while 23% (105 people) oppose it. An additional 27% (125 people) are unsure, 5% (24 people) would support it with certain conditions, and 13% (59 people) selected "Other.“ Key themes: • Strong Opposition and Emotional Distress • Primary Concerns About Mainland Relocation 20
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7 o Forced Displacement from the island/ Family Separation o Personal and Family Impact Stories • Ferry Service Complications o Visiting Challenges • Staffing and Quality of Care Perspectives o Understanding of Staffing Challenges o Conditional Support for Quality Care • Use of Purpose-Built Facility o Underuse of Purpose-Built Facility • Distrust of Motivations o Suspicion of Cost-Cutting • Demographic and Demand Considerations o Ageing Population Needs • Impact on Other Services o Pressure on Healthcare System There were 23 respondents to the Staff, Professionals and Wider Partners survey. 96% (22 out of 23 participants), are residents of the Isle of Arran while only 4% (1 participant) is not. The majority of respondents (61%) did not support the proposed change. Four professionals (17%) agreed with the proposal, with only one qualifying their feedback by stating, "If that's all we can staff, it's all we can staff." How does any existing data differ between islands? The options appraisal paper, which has been published as an appendix to the Integration Joint Board report (IJB), 21 August 2025 is available on the IJB page of the North Ayrshire Council website. The option appraisal has undertaken a detailed analysis of the island community on Arran and comparisons with other islands with older people care homes. 21
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8 Care Homes – Island Comparison Comparisons with other island services are covered below. We used the following classifications from the Scottish Government. Islands/island groupings with mid to high population levels, have populations which are higher than at least 60% of the islands covered in this chapter, but lower than 10% of the islands covered by this chapter The population of these islands varies significantly. The islands in this category are: • Bute (population 6,498) • Uist & connected isles (population 4,846) • Arran (population 4,629) • Islay (population 3,228) • Mull (population 2,800) • Great Cumbrae (population 1,376) • Barra & Vatersay (population 1,264) • Whalsay (population 1,061) • Yell (population 966) • Tiree (population 653) • Unst (population 632) • Westray (population 588) • Seil (population 551) • Sanday (Orkney) (population 494) • Hoy & Walls (population 419) • Bressay (population 368) A comparison of Care Homes within these areas found that the national average of bed spaces available is twelve as described at Chart 1. 22
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9 Chart 1: Care Home Capacity There are 16 Care Homes within North Ayrshire. Montrose House on Arran currently has a vacancy rate of 13.3%, which is significantly higher than the overall average vacancy rate across care homes in North Ayrshire, which stands at approximately 6.6% [see chart 2]. 23
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10 Chart 2 Vacancy % by Care Home 24
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11 Are there any existing design features or mitigations in place? The Health and Social Care partnership has provided accommodation for staff who travel to Arran to deliver key services on Arran. Nursing and Care staff also receive a financial enhancement to work on the isle of Arran. However, neither mitigation have resolved the staffing challenges at Montrose House. STEP THREE – CONSULTATION Who do you need to consult with? The engagement will be open to all members of the public, community organisations, residents and families using Montrose House and staff. How will you carry out your consultation and in what timescales? Montrose House Engagement drop in Event was held within Montrose House by the Arran Senior Management team on 22nd July 2025. A public online survey was opened on the 15 July 2025 to 1st August 2025 and paper copies were also made available. Staff supported people to complete the paper copies. A staff online survey was opened on the 25th July to the 1st August 2025. 10 % of the island community contributed their views. What questions will you ask when considering how to address island realities? A full analysis of the questions asked is available on the IJB page of the North Ayrshire Council website. With reference to the consultation undertaken, due to the nature of some of the feedback which includes the personal circumstances of some respondents, and in order to avoid any risk of identification, full details have not been made publicly available, however, full details of consultation responses have been shared with Integration Joint Board members on a confidential basis. What information has already been gathered through consultations and what concerns have been raised previously by island communities? Previous engagement on the island plan highlighted the following areas of concern: - Staff sustainability due to the high cost of housing, reducing the attractiveness of living on the island. 25
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12 - Growth in the aging population of the island and the lack of working age population to provide support, Is your consultation robust and meaningful and sufficient to comply with the Section 7 duty? The Consultation undertaken between 15 July 2025 to 1st August 2025 has been determined by officers as robust and meaningful and sufficient to comply with the Section 7 duty. STEP FOUR - ASSESSMENT Does your assessment identify any unique impacts on island communities? As a result of a lack of staffing to offer social care support, which has raised concerns about safe staffing levels the following new changes are proposed: a) Older People Day Service – the traditional day service provision closed due to infection control requirements during the Covid 19 pandemic and has not re-opened. A service review, alongside stakeholder engagement, is taking place to identify a day service model which will best meet the needs of future service users, and their carers. Proposal to explore a hybrid day-case model, that will be provided in-house and community-based working alongside the activity coordinator b) Montrose House continues to face significant operational challenges related to staffing levels, due to the limited availability of social care trained staff on the island. As a result of these staffing challenges there has been a reliance on agency workers, to ensure safe staffing levels within the home. Unfortunately, at times agency staff cover can be irregular, which affects the continuity and quality of care delivery. As a result the Montrose House Care Home budget has been overspent over the last 2 financial years. There are currently 12 residents, and the option appraisal proposal recommends a reduction from 15 permanent beds to 10 permanent care beds and 1 respite bed. This will improve service resilience, safety and quality, by having a sustainable service with a staffing model which does not rely on agency staff. If achieved, this will result in improved safe care delivery and the overspend being reduced significantly. c) The review is also proposing the development of an admissions policy to prioritise those with familial ties on the island to access the Montrose House beds. 26
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13 The assessment identifies that not all residents of Arran will be able to be supported at Montrose House in the future and that off island placements may cause distress and additional expenses to those visiting, as described in the section below. It should also be noted that North Ayrshire Health and Social Care Partnership currently funds 816 placements for adults over 65 in care homes within and outside North Ayrshire. Montrose House accounts for 1.6% of the total service users currently funded for care home places. Of these, 606 residents (74%) are accommodated in care homes based in North Ayrshire, while 210 residents (26%) are placed outside the local authority area. Does your assessment identify any potential barriers or wider impacts? The assessment has identified the following impacts and barriers. In the event that a relative requires to move off island for residential care, it is recognised that this may cause anxiety and distress for the resident and family member; and although the island social work teams will work with families to reduce their isolation e.g. referrals for support from carers groups, all of this distress cannot be mitigated against. There will also be longer travel times and additional travel expenses. Currently the foot passenger day return cost is £ 10.20 per adults and £5.10 per child; subject to concessions. There may also be bus/train fares from ferry to home and ferry to care home. It also costs £51.20 to take a car on a return trip. There may also be car fuel costs from ferry to home and ferry to care home. The HSCP has no mechanisms available to reduce or mitigate these costs, noting the responsibility only extends to providing care and support for the individual requiring access to residential care. How will you address these? The HSCP has no mechanisms available to reduce or mitigate the issues highlighted above. You must now determine whether in your opinion your policy, strategy or service is likely to have an effect on an island community which is significantly different from its effect on other YES. 27
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14 communities (including other island communities). STEP FIVE – PREPARING YOUR ICIA Assess the extent to which you consider that the policy, strategy or service can be developed or delivered in such a manner as to improve or mitigate, for island communities, the outcomes resulting from it. In the event that a relative requires to move off island for residential care, it is recognised that this may cause anxiety and distress for the resident and family member; and although the island social work teams will work with families to reduce their isolation e.g. referrals for support from carers groups, all of this distress cannot be mitigated against. There will also be longer travel times and additional travel expenses. Currently the foot passenger day return cost is £ 10.20 per adults and £5.10 per child; subject to concessions. There may also be bus/train fares from ferry to home and ferry to care home. It also costs £51.20 to take a car on a return trip. There may also be car fuel costs from ferry to home and ferry to care home. The HSCP has no mechanisms available to reduce or mitigate these costs , noting the responsibility only extends to providing care and support for the individual requiring access to residential care. Consider alternative delivery mechanisms and whether further consultation is required. There are no other delivery models available due to the lack of staffing capacity. Describe how these alternative delivery mechanisms will improve or mitigate outcomes for island communities. Any further required mitigations will continue to be assessed on an ongoing basis. Identify resources required to improve or mitigate outcomes for island communities. In order to sustain current levels of bed capacity on Arran this would require an additional £0.50million per annum, to cover agency staff costs. However this will not ensure continuity of care as staff from agencies are often not regular. 28
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15 STEP SIX – MAKING ADJUSTMENTS TO YOUR WORK Should delivery mechanisms/mitigations vary in different communities? Montrose House on Arran is the only Health and Social Care Partnership managed care home and as a result this policy does not apply to the mainland, where care homes are delivered by the private independent sector. Do you need to consult with island communities in respect of mechanisms or mitigations? Island communities have provided detailed feedback on the proposals. A full analysis of the questions asked is available on the IJB page of the North Ayrshire Council website. In the event of any unintended consequences of this policy being identified in the course of ongoing monitoring, consideration will be given to appropriate steps which may be required to mitigate these across different communities as required, including whether further consultation is required. Have island circumstances been factored into the evaluation process? The particular circumstances on Arran have factored into the evaluation process as set out above. Have any island-specific indicators/targets been identified that require monitoring? A target of 10 permanent beds and 1 respite bed has been identified. A suite of performance measures will be developed for the hybrid day service model as it is developed. How will outcomes be measured on the islands? Monitoring the number of residents taking up day services and the number of residents waiting for a bed at Montrose House and those being placed off island, will provide a sufficient level of information to assess the ongoing impact of the policy and any associated outcomes. A suite of performance measures will be developed for the hybrid day service model as it is developed. How has the policy, strategy or service affected island communities? This would be monitored on an ongoing basis. How will lessons learned in this ICIA inform future policy making and service delivery? This would be assessed on an ongoing basis as the policy was implemented. 29
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16 STEP SEVEN – PUBLISHING YOUR ICIA Have you presented your ICIA in an Easy Read format? No. Does it need to be presented in Gaelic or any other language? This is not considered proportionate for the Island or wider North Ayrshire community Where will you publish your ICIA and will relevant stakeholders be able to easily access it? The completed ICIA will be included in a report to North Ayrshire integration Board scheduled for 21 August 2025, therefore, the information will be publicly available. Who will sign-off your final ICIA and why? ICIA approved by: ……………KerryKerry Logan……………………………………………………………… Position: ……………Head of Health & Community Care……………………………………………………………… Signature: …………………………………………………………………………… Date completed: ………………12082025…………………………………………………………… ICIA approved by: …………………………………………………………………………… Position: …………………………………………………………………………… Signature: …………………………………………………………………………… Date completed: …………………………………………………………………………… 30
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Application for Review of Decision Relating to Island Community Impact Assessment Regulation 5 of The Island Communities Impact Assessments (Publication and Review of Decisions) (Scotland) Regulations 2020 Notes: 1. This form is to be used by an applicant applying for a review of a decision relating to an island community impact assessment (“ICIA”) under regulation 5 of the Island Communities Impact Assessments (Publication and Review of Decisions) (Scotland) Regulations 2020. 2. You may download this form and complete it manually or electronically. 3. If you complete the form manually, please do so using black or blue ink and capital letters. 4. Whether you complete the form manually or electronically, you may continue any answer on a separate sheet of paper. If you do this, please— • indicate on the form where any answer is given or continued on a separate sheet, • indicate on each separate sheet the question number(s) to which it relates. 5. This form must be submitted directly to the relevant authority identified in Section 3. For details of where to send this form and attached documents, please visit www.gov.scot and search for “empowering our island communities”. 6. Failure to supply all relevant information could invalidate your application. Section 1 - Who Is Applying 1.1 Please put an “X” in the relevant box:— Applicant is an individual ☒ Applicant is a community controlled body ☐ Applicant is a relevant local authority☐ 1.2 Please state who is applying for the review: Section 2 – Details Of Who Is Applying 2.1 Please supply the contact details of the applicant: Postal Address: Postcode: E-mail: 2.2 Please confirm if you agree to all correspondence regarding your application being sent by e-mail (put an X in the box)? Yes☒ No☐ Information Redacted under Regulation 9(2) Info redacted under Reg 9(2) 31
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Section 3 – Details of Relevant Authority 3.1 Please provide the name of the relevant authority who made the decision which you are applying to have reviewed: North Ayrshire Council / North Ayrshire IJB Section 4 – Grounds for Review 4.1 Please mark an “X” in the relevant box to confirm which ground applies to this application (tick one box only, unless both grounds (ii) and (iii) apply): i. the applicant disagrees with the published explanation of the relevant authority for not preparing an island communities impact assessment, ☐ ii. the applicant considers that the relevant authority, in making its decision, has failed to describe the likely significantly different effect of the policy, strategy or service (as the case may be), ☐ iii. the applicant considers that the relevant authority, in making its decision, has failed to assess the extent to which the relevant authority considers that the policy, strategy or service (as the case may be) can be developed or delivered in such a manner as to improve or mitigate, for island communities, the outcomes resulting from it, or ☒ iv. the relevant authority has reviewed a policy, strategy or service and has decided not to prepare an island communities impact assessment for that policy, strategy or service and has not published an explanation for not preparing an island communities impact assessment and the applicant considers that policy, strategy or service has an effect on an island community which is significantly different from its effect on other communities (including other island communities) in the area in which the relevant authority exercises its functions. ☐ Section 5 – Details of Decision to which the Application Relates 5.1 Please supply the following details about the decision: Has an ICIA been prepared? (put an X in the box)? Yes☒ No☐ If Yes, date of publication of ICIA: 21 September 2025 If No, has the relevant authority published reasons for not preparing an ICIA? (put an X in the box) Yes☐ No☐ If Yes, date of publication of reasons: If No, please provide details of the policy, strategy or service to which this application relates: 32
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Section 6 - Statement of Reasons 6.1 You MUST state, in full, why you are applying for a review of the relevant authority’s decision. Your statement must set out all matters you consider require to be taken into account in determining the review. Note: you might not have a further opportunity to add to your statement of reasons at a later date, so it is essential that you produce all of the information you want the decision-maker to take into account. You will though be entitled to comment on (i) any additional matter which may be raised by the relevant authority in its response to your application, or (ii) any representations the relevant authority might receive from any other person or body. State the reasons for your application and all matters you wish to raise here. (If necessary, this can be continued or provided in full on a separate document.) The decision did not take into account the requirements of Arran residents, there was no discussion with residents merely a presentation, which was/is inadequate. No time was allowed for any alternative proposals to be presented or discussed. This is contrary to the Islands plan laid down by Scottish Government. Provision for elderly residents has already been cut by private care homes closing in the last 2/3 years, the local authority built a new care home on Arran which they guaranteed would have full use of the 30 beds provided, they have reneged on this guarantee and this needs fully investigated. Elderly relatives/friends of those in care also need to be treated with dignity and respect, having to travel to care homes on the mainland given our poor ferry service causes distress and worry for these relatives, and younger relatives who want to stay in touch with those in care are normally working and unable to regularly visit. Nobody who has spent all/most of their lives living on Arran wishes to be banished – and that is exactly how it feels – to a care home on the mainland, in a place to which they have no connection whatsoever, and where they can rarely see family r friends. The elderly on islands deserve the same amount of consideration and care as those on the mainland, not to be treated as if they, and their family’s wishes are dismissed as being irrelevant. Visiting a care home on the mainland is not the same for islanders as it is for mainland dwellers. For us, it involves a long day of travel and can take more than 2-3 hours from leaving home to even reach the mainland, and the same time of return journey, but also having to work with ferry times and cancellations into the bargain. If NAC didn’t intend to fully open the new Montrose House and make all beds available to islanders, what on earth did they spend the money building it for? There must be ways and means to provide the staffing levels required by training local people, and having sensible shift times to fit in with family life, this is not rocket science and if there was the will to do it, it could – and should - happen. 33
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We need a proper review of the decision made on our behalf, which has not been to islanders benefit at all. Section 7 - Statement Demonstrating Direct Effect 7.1 You MUST state, in full, how you have been, or are likely to be, directly affected by the policy, strategy or service to which the decision relates. I have lived on Arran for 52 years, I hope I never need to go into care, but if I do, then the last place I want to have to go to receive that care, is some mainland care home. Section 8 - List of Documents / Evidence 8.1 Please provide a list of all documents, materials and evidence which you have provided with your application and intend to rely on in support of your application and ensure that the documents are clearly numbered (if necessary, this can be continued or provided in full on a separate document). n/a The relevant authority will publish all documents relating to the review on its website. If you take part in the review process or use the website of the relevant authority, the relevant authority may collect certain information about you. If the relevant authority is the Scottish Ministers, to find out more about what information is collected and how the information is used and managed, please read the Scottish Government island community impact assessments review of decisions procedure privacy notice on the Scottish Government Website www.gov.scot. For any other relevant authority, please see the website of that relevant authority for details of their privacy notice. Declaration I apply to the Relevant Authority as set out on this form and supporting documents. Signed Date 08/11/2025 This form and all supporting documents should be sent to the relevant authority identified in Section 3. Details of the contact addresses for each relevant authority can be found on the Scottish Government Website www.gov.scot. Info redacted under Regulation 9(2) 34
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Appendix 3 Concerns raised in written representations about the impact of the policy on the island community and the method of consultation • Impact on Residents and Families (if care home placement is on the mainland); (100%) • Inadequate Consultation & Engagement (90+%) • Non-compliance with the Islands (Scotland) Act 2018 (80%) • Workforce and Recruitment Model (75%) • Loss of Day Services & Impact on Carers (60%) • Long term risk to community sustainability (50%), and • Lack of Transparency, Data Quality and Decision Making (40-50%) 35
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Integration Joint Board 12th February 2026 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 ICJ Improving the Cancer Journey FOISA Freedom of Information in (Scotland) Acts 2002 SPOC Single Point of Contact PHS Public Health Scotland ICJ Improving Cancer Journey ArCaS Arran Cancer Support RCN Royal College of Nursing 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 and highlights local and national information for awareness. Agenda Item 5 37
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3. CURRENT POSITION National Developments 3.1 Self Harm Strategy Interim Report & Reflection and Improvement Tool In November 2023 COSLA and Scottish Government jointly published the �� Self Harm Strategy and Action Plan with the aim of ensuring that anyone affected by self harm receives compassionate support, without fear of stigma and discrimination. A ��midterm report on the Strategy and Action Plan was published in December 2025 highlighting where progress has been made, including in relation to offers of training and support for affected individuals and professionals. . Also published in December 2025 was a �� Reflection and Improvement Tool designed to help leaders consider and support local improvement in response to self- harm in line with the Scottish Self-Harm Strategy and Action Plan. This can be utilised by council staff and partners either individually or together. Consultations 3.2 Extension of Freedom of Information (Scotland) Act 2002 (FOISA) �� Extension of Freedom of Information in (Scotland) Acts 2002 (FOISA) to private and third sector providers of care home and ‘care at home’ services - Consultation – Scottish Government • The Freedom of Information (Scotland) Act 2002 (FOISA) gives people important rights to ask for and receive information from government and public services in Scotland. In doing so it places clear obligations on Scottish public authorities to provide people with information about their work. • Through this consultation, the Scottish Government is seeking views on whether these rights and obligations should, where possible, be extended to private and third sector (i.e. voluntary and not-for-profit) providers of care home and ‘care at home’ services. The consultation closes on 30th March 2026, the HSCP will provide feedback to the consultation. 3.3 Future of Secure Care & Single Point of Contact (SPOC) �� The future of secure care and the single point of contact (SPOC) for victims in the Children's Hearings System - Consultation – Scottish Government 38
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This consultation seeks views on a transformative future for secure care, and for the children who may need its support, across the following inter-linked issues: • The case(s) for the future nationalisation and / or the national co-ordination of secure care in Scotland, including the potential contribution of the National Social Work Agency; • Depending on the adopted future approach, the design of funding and commissioning models to support consistent, high quality provision; • Expanding or redefining the statutory concept of “secure accommodation” or “secure care” and revising the criteria for when a child may be placed in restrictive environments. • Models proposed in the ‘Reimagining Secure Care’ report – ‘flex secure’, ‘community-based hubs’ and ‘multi-disciplinary teams’; • Standards for the safe and secure transportation of children, whether to secure care facilities or to essential appointments during their stay in secure care, or wider transport needs when secure transport is required; and • The establishment of a Single Point of Contact (SPOC) for victims affected by harmful behaviour that is being considered within the youth justice system. The consultation closes on 16th April 2026, the HSCP will provide feedback to the consultation. 3.4 Mental Welfare Commission - Right to Advocacy Report Mental Welfare Commission Scotland published the Right to Advocacy report on 19 January 2026 which shows that: Advocacy provision for adults • Planning and commissioning of advocacy services: the majority of respondents confirmed that this is carried out at HSCP level or jointly with health boards and local authorities. • Strategic advocacy plans: 65% (n=20) of respondents reported that they have a plan in place and six confirmed that plans are in the process of being developed. Advocacy provision for children and young people • Integrated children’s services plan: 97% (n=30) of respondents reported that they have a plan in place, and 23 contain a reference to the provision of advocacy. Independent advocacy services commissioned for adults, children and young people • 55% (n=17) of respondents have confirmed that their budget for mental health, learning disability or dementia independent advocacy has not changed over the last two years. • 51% (n=44) out of 86 advocacy organisations are allocated funding for a term of one year only. 39
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A copy of the full report is available here North Ayrshire responded to the survey and our response confirmed: • The HSCP commission advocacy for both adults and children, • A Strategic Advocacy Plan is in place, • This is reflected in our Children’s Services Strategic Plan, • The resource allocated to advocacy support has not reduced, • Our commissioned advocacy providers have multi-year contracts. 3.5 Audit Scotland Reports Audit Scotland published two reports in January 2026 :- Delayed Discharges, a sign of wider challenges in health and social care A joint report by the Auditor General for Scotland and the Accounts Commission warns delayed discharge has a significant effect, despite impacting only around 3% of hospital patients. People medically ready to leave spent 720,000 unnecessary days in hospital in 2024/25. Whilst the full financial impact is unknown, the cost to the NHS in hospital days alone is an estimated £440 million a year. The causes are complex, including rising demand for health and social care services, financial pressures, long- standing recruitment and retention problems across Scotland and for some, not having a Power of Attorney in place. Reducing delayed discharges is a priority for the Scottish Government and their partners in health and social care, with significant activity underway to tackle this. But a lack of evaluation of initiatives across the country means it is difficult to measure what is having the greatest impact and whether these initiatives represent value for the money and time spent. Community Health and Social Care : Performance 2025 A lack of comprehensive and consistent national performance information makes it difficult to assess the impacts of integration. Audit Scotland have produced a briefing and data tool designed to support Integration Authorities (IAs) and Health and Social Care Partnerships (HSCPs) in comparing how services are performing locally and across Scotland. The aim is to highlight the need for better performance information, supporting benchmarking and self-assessment using the national information that's available. Both Audit Scotland reports will be considered at a future meeting of the IJB Performance and Audit Committee. 40
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3.6 Public Health Scotland (PHS) – New 10 Year Strategy Public Health Scotland have launched a new 10-year strategy, Together we can. The strategy sets a clear and ambitious direction for improving health and wellbeing across Scotland, driven by evidence, collaboration, and the voices of people and communities across the country. Scotland faces urgent challenges to health and wellbeing, including persistent inequalities, preventable conditions, and rising pressure on public services. The strategy is a commitment – not just a list of aspirations – to deliver real, lasting change and aim to improve average life expectancy by at least one year within the next decade and to narrow the life expectancy gap between the poorest 20% of areas and the national average. The approach is grounded in five key drivers of action: • Building a prevention-focused system • Improving social and economic conditions • Strengthening places and communities • Enabling healthy living • Providing equitable access to health and care. North Ayrshire Developments 3.7 Delivering Social Care Services Within Budget : Consultation Closed The consultation exercise, which ran for six weeks and closed on Friday 16 January, was set up to gather the thoughts North Ayrshire residents, community groups, staff, and partner organisations on their priorities around how NAHSCP delivers social care services within budget. The partnership is facing significant financial pressures, with demand for its services continue to rise at an unprecedented rate. With the cost of providing these services also increasing - and funding not keeping pace with these additional challenges - NAHSCP is facing a projected budget deficit of around £17m in 2026-27. This will affect the level and types of care NAHSCP is able to provide across many of its services. Findings from the consultation will be analysed by NAHSCP’s Strategic Planning and Transformation team over the coming weeks, with a final consultation report being presented to North Ayrshire Integration Joint Board in March for consideration when setting the budget for 2026-27. The HSCP thank everyone who took the time to share their views. 41
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3.8 Improving the Cancer Journey for People on Arran A new service to ensure people living with cancer and their families are offered emotional, practical and wellbeing support is now available for Arran residents. The Improving the Cancer Journey (ICJ) service is jointly funded by Macmillan Cancer Support and the Scottish Government, working in partnership with NHS AA and the Health and Social Care Partnerships in North, East and South Ayrshire. The service aims to provide every person affected by cancer, including families and carers, with vital assistance in finding support for any non- clinical concerns they may have. Read more about the service in our news article. On Arran, the ICJ team is working closely with Arran Cancer Support (ArCaS) to deliver the service. Face-to-face appointments can be arranged at the ArCaS Hub at The Pier, Brodrick, over the telephone, or online via video call. The service is free and available to anyone, aged 16 and over, living on Arran that has been affected by cancer. This includes people living with cancer and those affected by cancer, such as partners, carers and family members. To find out more about how the service can help, or to book an appointment, please call 01563 827028, email aa.icj@aapct.scot.nhs.uk, or visit the NHS A&A website. 3.9 Care Inspectorate Inspection – Anam Cara Anam Cara, our respite service received a very positive report from the Care Inspectorate following an unannounced inspection in January 2026. The service received very positive findings across all evaluated areas, with the service rated Very Good (5) for supporting wellbeing, staffing, the care environment, and care planning. Inspectors highlighted the consistency and experience of the staff team, strong teamwork and a compassionate, person-centred approach that supported positive outcomes for people accessing short breaks. Health needs assessments and care plans were found to be comprehensive, personalised, and consistently updated, ensuring that individuals received high-quality, tailored support. Relatives and people using the service expressed high levels of satisfaction, emphasising the value of respite in reducing stress and providing reassurance that their loved ones were safe and well cared for. 42
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The inspection further identified significant strengths in the quality of the environment and overall experience offered at Anam Cara. The setting had undergone substantial refurbishment, creating a warm, welcoming, and homely atmosphere that enhanced people’s comfort during their stay. Opportunities for engagement, activities, and meaningful interaction were evident, contributing to a positive and enjoyable short-break experience. Congratulations to all the staff involved. 3.10 Finalist – RCN Scotland Nurse of the Year Awards The team behind the NHS Ayrshire & Arran Mental Health Unscheduled Care Assessment Hub have been recognised for their positive impact, being named among the finalists at this year’s Royal College of Nursing (RCN) Scotland Nurse of the Year Awards in the Mental Health category. The nurse-led hub was established in September 2024 following a pilot and is the first of its kind in Scotland. Based at Woodland View in Irvine, it hosts a patient-focused therapeutic space to support the delivery of compassionate care to patients with acute mental illness. The Mental Health Unscheduled Care service provides 24-hour access to mental health assessment and interventions and can accommodate up to five patients within a therapeutic environment for up to 72 hours. Since being established 18 months ago, the service has successfully: • Reduced the number of unscheduled admissions to acute adult inpatient mental health beds; • Brought community and inpatient services closer together to help create a smoother patient journey; • Reduced the waiting time for planned adult acute admissions, and • Reduced the number of initial assessments being carried out in acute wards – releasing resource for treatment. We wish the team every success for the Awards ceremony which will be held in April 2026. 4. IMPLICATIONS 4.1 Financial None 4.2 Human Resources None 43
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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 44
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Integration Joint Board 12th February 2026 Subject : Alcohol & Drug Partnership Strategy 2025-2028 Purpose : To present the ADP Strategy 2025-28 to IJB for awareness and endorsement. Recommendation : IJB to endorse the content of the North Ayrshire Alcohol and Drug Partnership Strategy. 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 ADP Alcohol and Drug Partnership 1. EXECUTIVE SUMMARY 1.1 This paper outlines the core strategic priorities for the North Ayrshire Alcohol and Drug Partnership (ADP) over the coming years. The strategy will help inform decision making and the distribution of ADP resources in line with national policy expectations and Public Heath Scotland priorities underpinned by a human rights and trauma- informed approach. 2. BACKGROUND 2.1 Developing our strategy This strategy has been developed following a review of existing plans and learning, engagement with people working in statutory and third organisations across North Ayrshire and with people with lived experience of alcohol and drug issues. The priorities and areas for action set out in this strategy will be progressed in partnership during the period of 2025 to 2028. Our work is focused on driving progress towards the following vision: Agenda Item 6 45
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People in North Ayrshire enjoy healthy lives, free from the harms of alcohol and drugs. Prevention is prioritised by building on our strengths and supporting our children, young people, and families. People experiencing alcohol and drug problems are supported with their own type of recovery within our communities. Everyone is treated with dignity and respect.” 2.2 Key Priorities and Cross Cutting Principles The strategy has been developed to focus on 6 key priority areas: 1. Families, Infants, Children and Young People 2. Reduce Risk and Facilitate Access to Treatment and Recovery 3. Workforce Support 4. Community Development and Support 5. Housing 6. Justice 2.3 The strategy outlines 6 cross-cutting principles that should underpin our overall approach to addressing the key priority areas: • Equalities and Rights • Evidence Informed • Lived Experience • Partnership Working and a Public Health Approach • Prevention • Relationship-based and Trauma-informed 2.4 The plan identifies our key assets and challenges, our local and national policy landscape and identifies our key enablers for success. It will be supported through a detailed subgroup actions plan which all members of our ADP contribute to. 3. PROPOSALS 3.1 The North Ayrshire Alcohol and Drug Partnership Plan 2025-2028 is attached as an appendix. It is proposed that the IJB endorse this document for continued implementation. 3.2 Anticipated Outcomes These priorities and principles ensure that people in North Ayrshire have access to safe, timely, evidence-based interventions, where they are treated with dignity and respect. Our ambition is to help limit the impact of problematic alcohol and drug use on children, young people, and families who are supported by a trauma-informed, competent, and committed workforce. 46
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The strategy recognises the importance of developing opportunities in the community beyond statutory services to support people to sustain their recovery. The development of local, peer-led opportunities informed by people with lived and living experience is vital to support recovery within North Ayrshire. Working in collaboration is crucial to improving outcomes for people particularly in relation to housing. In the lifetime of the strategy, there is a commitment to supporting initiatives that create more sustainable housing options for people impacted by alcohol and drugs, particularly those involved with the justice system. 3.3 Measuring Impact North Ayrshire Alcohol and Drug Partnership has a robust performance, commissioning and financial management framework incorporating multiple levels of scrutiny. This includes: • Reporting to Scottish Government via the ADP Annual Reporting Survey • A detailed Performance Management Report for IJB • Reporting directly to the Scottish Government on the implementation of the Medication Assisted Treatment Standards (MAT) • Regular scrutiny at ADP SMT and ADP Finance and Quality Assurance Group 4. IMPLICATIONS 4.1 Financial The ADP Strategy is developed on the basis that the ongoing commitment of funding from the Scottish Government to ADPs will continue. 4.2 Human Resources The plan outlines the value of the workforce across alcohol and drug services. 4.3 Legal Publishing the plan ensures the ADP are compliant with the expectations set out within the Partnership Delivery Framework. 4.4 Equality/Socio-Economic No risks have been identified. 4.5 Risk Changes in government policy direction could have an impact on this plan. This will be reviewed and adapted as necessary. 4.6 Community Wealth Building The ADP is committed to ensuring there are resources are available at a grassroot level ensuring recovery is visible within communities. 47
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4.7 Key Priorities The priorities outlined within this plan work towards limiting the impact of alcohol and drugs in our communities in North Ayrshire. 5. CONSULTATION The plan was developed after a period of consultation and engagement with key stakeholders across the alcohol and drug partnership Caroline Cameron, Director For further information please contact Michael McLennan, ADP Lead Officer michaelmclennan@north-ayrshire.gov.uk Appendices • Appendix 1, North Ayrshire Alcohol and Drug Partnership Strategic Plan 48
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PUBLIC INFORMATION North Ayrshire Alcohol and Drug Partnership Strategy 2025-2028 50
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PUBLIC INFORMATION Contents Foreword ................................................................................................................ 3 Introduction ............................................................................................................. 5 Our Vision ............................................................................................................... 7 Cross Cutting Principles ......................................................................................... 8 Equalities and Rights .......................................................................................... 8 Evidenced Informed .......................................................................................... 10 Lived Experience ............................................................................................... 10 Partnership Working & Public Health Approach ................................................ 10 Prevention ......................................................................................................... 11 Relationship-based and Trauma Informed ........................................................ 11 Families, Infants, Children & Young People ......................................................... 12 Empowering Children & Young People Through Education & Engagement ......... 13 Holistic, Early & Trauma-Informed Support for Families ....................................... 14 Safeguarding & Supporting Vulnerable Families, Infants & Children & Young People .................................................................................................................. 15 Reduce risk & facilitate access to treatment & recovery ....................................... 15 Delivering Safe, Accessible & Evidence-Based Treatment ................................... 16 Strengthening Recovery Pathways & Community Support ................................... 17 Reducing Harm & Promoting Safer Communities ................................................. 17 Workforce Support ................................................................................................ 19 Workforce Development, Collaboration & Wellbeing ............................................ 19 Community Development & Support..................................................................... 21 Community & Recovery Support Initiatives ........................................................... 21 Housing ................................................................................................................ 22 Housing & Recovery ............................................................................................. 22 Housing Pathway Improvement ............................................................................ 23 Justice .................................................................................................................. 23 Criminal Justice System & Recovery .................................................................... 23 51
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PUBLIC INFORMATION Foreword This strategy sets out the aspirations and activities of North Ayrshire’s Alcohol and Drug Partnership (NAADP), detailing the priorities and principles that the NAADP and partners are committed to progressing. It will guide our ongoing activities, investments and related monitoring and evaluation. As Independent Chair of the Alcohol and Drugs Partnership I am in the privileged position of being able to observe the tremendous work and collaboration that is going on across our services in the bid to free our communities from the all too often tragic impacts of drugs and alcohol. Statutory services workers within our Health and Social Care Partnership and within Education, our colleagues in the Police, Ambulance and Fire services, very often go above and beyond to support individuals and families affected by drugs and alcohol. Our third sector partners, offer a diverse range of additional supports and recovery options. Crucially, Recovery Development Workers in third sector and community organisations, who themselves have turned their own lives around, are using their experience and community connections to help others towards recovery. The NAADP Support Team has worked closely with all our partners and has undertaken a thorough process of consultation with groups within our recovery communities, with our young people and with other community representatives to establish a set of priorities for the NAADP which, alongside Scottish Government priorities, form the basis of this strategy. This has been ongoing for a significant period and many of the proposals are already underway. For example: • the NAADP has been active in supporting the embedding of the Medication Assisted Treatment (MAT) standards, • a pathway to Residential Rehabilitation has been established for those who need this, • Naloxone is now widely available to services and to local communities in North Ayrshire, • all schools in North Ayrshire are now involved in a developing drugs and alcohol education programme which is coordinated by the NAADP. I am in no doubt that lives are being saved in North Ayrshire as a consequence of these and other activities. However, we still face huge challenges. The drugs landscape constantly changes and we look with concern at the increasing availability of cheaper and more dangerous substances on our streets, and Scotland’s culturally embedded and often troubling relationship with alcohol carries on apace. North Ayrshire contains some of the most deprived communities in the country and it is within communities such as these that drugs and alcohol have their greatest impact. People are still dying as a result. We, in our ADP with all our partners, are committed to joint working and driving action to do all that we can to address these challenges. Our collective efforts and this strategy are aligned with broader work underway, in partnership with Public Health Scotland, to address health inequalities in North Ayrshire. People should be 52
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PUBLIC INFORMATION supported to live long; healthy and active lives and our strategy will fully support that aspiration for the people of North Ayrshire. Billy Brotherston Independent Chair, North Ayrshire Alcohol and Drug Partnership 53
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PUBLIC INFORMATION Introduction North Ayrshire Council has a joint plan focused on making North Ayrshire a fairer and more equal society for our residents and communities1. The plan acknowledges that we face some extremely complex challenges and emphasises the need for long- term and joined-up approaches, with communities at the heart of everything we do. • NHS Ayrshire & Arran's, "Caring for Ayrshire" vision focuses on: • Delivering care as close to home as possible, supported by community services. • Ensuring safe, effective, and timely access to specialist services when needed. • Creating an integrated health and care system that supports people from birth to end of life. • Encouraging individuals to take an active role in their own health and wellbeing. • Innovating and evolving services to meet future demands through collaboration with communities and partners North Ayrshire Health and Social Care Partnership2 set out a long-term plan for 2022 to 2030 to improve services and the health and wellbeing of the approximately 135,000 people who live in the communities across the area’s towns, villages, and islands, each with unique characteristics, strengths and challenges. North Ayrshire has areas of high deprivation and poverty contributing to high levels of poor health and wellbeing for many local people. The North Ayrshire Health and Social Care Partnership is working towards their vision that “People who live in North Ayrshire are able to have a safe, healthy and active life”, supported by five strategic priorities to: enable communities; develop and support our workforce; provide early and effective support; improve mental and physical health and wellbeing; and tackle inequalities. Analysis undertaken in 20253, highlighted that North Ayrshire has relatively low life expectancy for both men and women (75 years for men and 79 years for women in 2021-23), compared with other places in Scotland. Rates of under 75 mortality have increased in North Ayrshire since 2010. There are also large differences in life expectancy within North Ayrshire (for both men and women) related to levels of deprivation. North Ayrshire has rates of alcohol-related hospital admissions which are close to the Scottish average of 532 per 100,000 population. However, rates of admission vary across areas within North Ayrshire, strongly related to levels of deprivation. There is also variation by deprivation for rates of drug related hospital admissions, as with the data for Scotland as a whole, there are markedly higher rates among people living in the 20 percent most deprived areas. 1 North Ayrshire Council Plan 2 NAHSCP Strategic Commissioning Plan 3 Health Inequalities in Scotland 54
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PUBLIC INFORMATION In 2025 Public Health Scotland (PHS) reported that people in Scotland are drinking 50% above safe limits, with more deprived communities hit hardest4 and reported increased levels of drug-related harm5. PHS emphasise that alcohol and drug harms are closely linked to social and health inequalities and underscore the role that all services can play in collectively addressing this challenge, in line with the measures outlined in the Population Health Framework6. Publication of the updated 2023-24 data for PHS Alcohol Consumption and Harms dashboard in June 2025 revealed that, despite recent improvements, Scotland continues to face a significant alcohol problem, with adults who drink alcohol consuming an average of 21.6 units per week (more than 50% above the Chief Medical Officers' safe drinking guidelines for both men and women). The latest data highlighted stark inequalities, with people living in Scotland’s most deprived areas being six times more likely (compared to people in the least deprived communities) to be hospitalised or die from causes wholly related to alcohol7. The PHS Rapid Action Drug Alerts and Response (RADAR) report published in July 2025 reported concerning increases in naloxone administration incidents, emergency department attendances, and suspected drug deaths8. The findings highlighted the persistently high levels of drug related harm in Scotland and the serious impact of a rapidly evolving, toxic, and unpredictable drug supply. The North Ayrshire Alcohol and Drug Partnership (ADP) is a multi-disciplinary, non- statutory partnership bringing together statutory and third sector organisations, the Police and the Scottish Prison Service. This partnership is working together to tackle alcohol and drug issues in North Ayrshire, as part of the national approach set out in Scotland’s alcohol and drug strategy, ‘Rights, Respect and Recovery (2018) 9. It sets out a vision that Scotland is a country where “we live long, healthy and active lives regardless of where we come from” and where individuals, families and communities: • Have the right to health and life - free from the harms of alcohol and drugs; • are treated with dignity and respect. • are fully supported within communities to find their own type of recovery. In response to the high levels of drug deaths in Scotland, in 2021 the First Minister announced a new National Mission to reduce drug deaths and improve the lives of people impacted by drugs. In 2022 the Scottish Government published the National Drugs Mission Plan for 2022-202610 detailing the key aims to: prevent people from developing problem drug use; reducing harms from the consumption of drugs; getting more people into high quality treatment and recovery services; 4 Public Health Scotland information on alcohol consumption 5 Public Health Scotland information on drug harms increasing in Scotland 6 Scotland’s Population Health Framework 7 Alcohol consumption and harms dashboard 8 RADAR Quarterly Report 9 Rights Respect and Recovery Alcohol and Drug Treatment Strategy 10 National Drugs Mission Plan: 2022-2026 55
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PUBLIC INFORMATION addressing multiple and complex needs; and supporting families and communities affected by problem drug use. This National Mission complements and builds upon the ‘Rights, Respect and Recovery’ alcohol and drug strategy and whole system approaches to improving population health. Our Vision This strategy has been developed following a review of existing plans and learning, and engagement with people working in statutory and third organisations across North Ayrshire and with people with lived experience of alcohol and drug issues. The priorities and areas for action set out in this strategy will be progressed in partnership during the period of 2025 to 2028. Our work is focused on driving progress towards the following vision: “People in North Ayrshire enjoy healthy lives, free from the harms of alcohol and drugs. Prevention is prioritised by building on our strengths and supporting our children, young people, and families. People experiencing alcohol and drug problems are supported with their own type of recovery within our communities. Everyone is treated with dignity and respect.” There are six cross-cutting principles which will be embedded throughout our approach to implementing this strategy. These are detailed in the next section of this strategy document, followed by an outline of the key priorities we are focusing on. For each priority we have detailed the key areas of activity, the outcomes we are collectively working towards, and the actions being progressed. A summary of the strategy vision, key priorities, and cross-cutting principles is provided in the diagram below. This strategy provides the overarching framework for our future action planning, commissioning, and funding decision-making, as well as our ongoing monitoring and evaluation activities. 56
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PUBLIC INFORMATION Cross Cutting Principles Six cross-cutting principles are integrated throughout our approach to implementing this strategy. They are all inter-related and equally important. They are listed below in alphabetical order. Equalities and Rights This strategy principle is being progressed by: • Responding to and working to address the high levels of poverty within North Ayrshire, working with an understanding of how people are affected by multiple and complex disadvantage. • Continue to raise awareness of Charter and include as key principle in National Specification for Alcohol & Drugs Services and the revised Partnership Delivery Framework for ADPs • Monitoring data of impacts for people with protected characteristics. • Decision-making and implementation of actions informed by understanding of differences by the nine protected characteristics under the Equality Act 2010 (age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation). • Implementing gender-informed approaches that recognise the influence of gender on individuals’ needs and experiences, supporting more effective and personalised care across services / sectors. 57
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PUBLIC INFORMATION • Upholding children’s rights as set out in the United Nations Convention on the Rights of the Child (UNCRC) and Human Rights (Charter of Rights). 58
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PUBLIC INFORMATION Evidenced Informed This strategy principle is being progressed by: • Decision-making and implementation of actions informed by available national and local data and evidence. • Monitoring and sharing information from the Rapid Action Drug Alerts and Response (RADAR) system. • Reviewing drug related deaths (including information from North Ayrshire Drug and Alcohol Recovery Services (NADARS) and wider ADP partners) to better understand the circumstances leading to tragic deaths and informing improvements to operational practice across the partnership. This includes consideration of protective factors, risk, significant life events, and areas for development and learning. • Monitoring and evaluation of implementation of this strategy. Lived Experience This strategy principle is being progressed by: • Working with and valuing experiences of people with lived experience of addiction and recovery and their family and friends. • Ensuring the ADP and partner activities are informed and driven by the lived experience of people and communities most affected by decisions and actions being progressed. • Engaging with children and young people. • Ongoing processes to ensure individual and community lived experience is informing decision-making and implementation of actions. • Recruiting and supporting people with lived experience in the workforce. Partnership Working & Public Health Approach This strategy principle is being progressed by: • Valuing and building on the strengths of partnership working across statutory and voluntary sectors and services and community groups. • Progressing inter-related actions across the determinants of health (including actions related to employment support, housing, community environment, tackling poverty) to support people’s health and wellbeing and reduce the risk of alcohol and/or drug harms and other health challenges. • Taking a life-course approach to understanding the causes and consequences of alcohol and drug use, with a priority focus on support for families, infants, children, and young people. • ADP supporting and working with partners across North Ayrshire, Pan- Ayrshire collaborations, and other regional and national partnerships. 59
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PUBLIC INFORMATION Prevention This strategy principle is being progressed by: • Integrating actions on prevention of alcohol and drug harm across all the priority areas for action detailed in this strategy. • Sharing information across whole population regarding alcohol and drug related harms. • Providing support for people across all life-stages impacted by alcohol and drug harm, both through their own use of alcohol and drugs and use by a family member and others. • Having a priority focus on supporting families, infants, children, and young people, linking to related actions to fulfil children’s rights and The Promise11 commitment to ensure that all children grow up loved, safe and respected. Relationship-based and Trauma Informed This strategy principle is being progressed by: • Building relationships and providing non-judgemental support to tackle stigma and ensure people and families can access help and care. • Providing the workforce with appropriate training, supervision, and wellbeing support to care for people with trauma, and where relevant to their role to provide effective, safe psychological therapies. • Providing trauma-informed services and support that recognises the impacts of trauma and responds in ways which supports resilience and recovery for individuals and families and avoids re-traumatisation. • Valuing and including the views and experiences of people in our workforces and people with lived experience. Key Priorities We have identified several key priority areas for action that are critical to driving progress on achieving our vision that: “People in North Ayrshire enjoy healthy lives, free from the harms of alcohol and drugs. Prevention is prioritised by building on our strengths and supporting our children, young people, and families. People experiencing alcohol and drug problems are supported with their own type of recovery within our communities. Everyone is treated with dignity and respect.” The diagram below provides an overview of these key priorities and the associated outcomes. The following sections provide more detail about each priority, including the key areas of activity, the outcomes we are collectively working towards, and the actions being progressed. 11 The Promise 60
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PUBLIC INFORMATION Families, Infants, Children & Young People Children and young people (CYP) in North Ayrshire consistently identify addressing alcohol and drug issues as their top priority, with many sharing concerns for themselves, their peers, family members, and people across their community. Supporting families, infants and CYP is a key priority for this strategy, to help ensure support is provided as early as possible and fewer people develop problem drug and alcohol use in the longer term. Throughout our work we will take a children’s rights- based approach in line with the UNCRC and aligned with the Getting it right for every child (GIRFEC) national approach to ensuring the right support at the right time12 and The Promise13 ambition for all children and young people to grow up loved, safe and respected so that they realise their full potential. Our partnership work focused on families, infants and CYP encompasses the following main areas of activity, including the outcomes (Outcomes 1 to 3) we are working towards, and the associated key actions. 12 Getting It Right for Every Child (GIRFEC) Strategy 13 The Promise Scotland Strategy 61
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PUBLIC INFORMATION Empowering Children & Young People Through Education & Engagement Key Actions Outcome 1: Children and young people are informed, empowered, and supported through accessible education, outreach, and engagement initiatives that promote health, wellbeing, and resilience. Education and prevention: • Continue ‘Champions for Change’ in primary schools. • Sustain S1 Roadshows and develop new educational resources. • Pilot peer facilitation and health education at Irvine Royal Academy. • Expand and develop attainment support in schools. • Deliver staff training on drug trends and ADP pathways. • Involve our lived experience workforce in engaging with young people as part of effective prevention activities. Outreach and support: • Increase youth work outreach at Irvine Beach and other hotspots, especially during warm weather in partnership with the Connected Communities (Community Learning and Development) service in North Ayrshire. Support for high-risk and CYP not in school • Strengthen referral pathways from housing, justice, and social services. Consistent messaging and peer support • Work with partners to ensure consistent communications regarding risk and harm. • Train peer mentors to support friends disclosing substance use. • Use social media campaigns to reach CYP with harm reduction messages. Parent and carer engagement • Engage with parents in schools and provide information about alcohol and drugs. • Host community-based information sessions beyond school settings. • Distribute resources via GPs, food banks, and libraries. • Offer online webinars and accessible digital materials. Coordination and directory • Maintain and promote a directory of support services for CYP and families. • Strengthen partnership working across sectors to ensure consistent, early intervention. 62
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PUBLIC INFORMATION Holistic, Early & Trauma-Informed Support for Families Key Actions Outcome 2: Families are supported early and holistically to build resilience, strengthen relationships, and reduce the impact of substance use and poverty, enabling children to thrive Early intervention and relationship-based support: • Maintain and develop provision of early and effective support to children, young people and families. Whole-family recovery and therapeutic support • Sustain and develop the Stronger Families service to support recovery and holistic family needs. • Enhance joint work with third sector and statutory services on skills development and relationship-building. • Provide ongoing support to families leaving Harper House and young people in residential detox/rehab settings. Targeted and intensive family support: • Assess and address the gap in support to prevent Foetal Alcohol Spectrum Disorder (FASD) through education and early intervention. • Develop targeted, intensive support pathways for families with complex needs, alongside universal early help. • Increase focus on support for children under 12, particularly those affected by parental substance use. • Enable families to access therapeutic support for both parents and children. 63
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PUBLIC INFORMATION Safeguarding & Supporting Vulnerable Families, Infants & Children & Young People Key actions Outcome 3: Infants, children and young people are safeguarded and supported through integrated, trauma-informed services that prioritise family unity and long- term wellbeing Integration and safeguarding: • Strengthen integration of ADP work with child protection structures, Children and Families Affected by Substances Group and Child Protection Committee. • Progress actions to safeguard CYP from criminal exploitation, including drug dealing, running drugs, and drug debts. • Align family support with The Promise to help keep families together safely. Care experienced children and young people: • Sustain and develop support services for care experienced children and young people. • Provide targeted support for kinship carers, particularly around trauma and FASD. Family recovery and workforce development: • Explore implementation of the CRAFT model (Community Reinforcement and Family Training) to empower families and carers in the recovery journey. • Develop staff capacity to deliver trauma-informed, family-centred support. Reduce risk & facilitate access to treatment & recovery Our partnership work focused on reducing risk and facilitating access to treatment and recovery encompasses the following main areas of activity, including the outcomes (Outcomes 4 to 6) we are working towards, and the associated key actions. 64
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PUBLIC INFORMATION Delivering Safe, Accessible & Evidence-Based Treatment Key actions Outcome 4: People affected by substance use have access to safe, person-centred, and evidence-based treatment options that meet their individual needs and support their recovery journey Clinical standards and access: • North Ayrshire Drug & Alcohol Recovery Service (NADARS) to continue to provide a wide range of support and interventions, including support to stop substance use, mental health services, physical and sexual health support, needle exchange, and the implementation of the Medication Assisted Treatment (MAT) Standards. • Delivery of residential detoxification and rehabilitation through Ward 5 at Woodland View. • Implementation of the North Ayrshire Non-Fatal overdose pathway System improvement and equity: • Implementation of the Residential Rehabilitation Action Plan14. • Implementation of the Co-occurring Mental Health and Substance use pathway15. Policy and strategy: • Collaborate with Public Health Scotland (PHS) to inform national alcohol and substance use strategies. • Continue to progress Recovery Orientated System of Care (ROSC), in line with the national, ‘Rights, Respect, and Recovery’ strategy16, to guide integrated, person-led approaches. 14 North Ayrshire Residential Rehabilitation Information 15 Community alcohol and drug services 16 Rights, Respect, and Recovery: Alcohol and Drug Treatment Strategy 65
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PUBLIC INFORMATION Strengthening Recovery Pathways & Community Support Key actions Outcome 5: Recovery is supported through integrated pathways, peer-led initiatives, and community-based services that promote hope, connection, and long-term wellbeing Recovery culture and access: • Turning Point Scotland Prevention, Early intervention, and Recovery Service (TPS PEAR) to continue to provide person-centred, accessible support and interventions to people on their recovery journey. • Community organisations supported to promote inclusive, person-centred recovery opportunities in the community. • Develop more opportunities in the evening and weekend to increase levels of engagement and activity for people impacted by drugs and alcohol. Reducing barriers and tackling stigma: • Identify and reduce barriers to support for recovery for all people, including providing trauma-informed and gender-informed support. • Develop our approach in North Ayrshire to reduce stigma around specific recovery models (e.g., 12 Step, mutual aid, community groups) to prevent disengagement and enhance partnership working. Integrated support: • Improve information sharing across organisations to streamline access and referrals. Reducing Harm & Promoting Safer Communities Outcome 6: Individuals, families, and communities are protected from the harms of substance use through proactive harm reduction, training, and accessible information Key actions Naloxone access and training: • Expand availability of Naloxone. • Improve staff and community training (including First Aid basics like recovery position and airway maintenance). • Continue to develop our communications plan regarding naloxone. Harm reduction resources: • Provide up-to-date communication and harm reduction information and • resources education on emerging synthetic substances and contaminants. • Develop and share clear, accessible information on drug trends and risks 66
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PUBLIC INFORMATION • Raise community awareness about new synthetic substances and their dangers. • Develop new training informed by drug trends. Collaboration and systems improvement: • Continue to engage with people with lived experience for feedback on service provision, strengths, and to identify areas for development. 67
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PUBLIC INFORMATION Workforce Support People across our workforce supporting individuals impacted by substance use are undertaking critical work and can face difficult challenges, for example when individuals relapse, become ill or tragically lose lives, and they witness the associated impacts on families and communities. It is therefore crucial members of our workforce are equipped with the right knowledge and skills, enabled to work with trauma-informed and multi-agency approaches, and supported with their own wellbeing. This may include help for vicarious trauma for all members of the workforce (including those with lived experience of issues related to alcohol and drugs). Our partnership work focused on workforce support encompasses the following main areas of activity, including the outcomes (Outcomes 7 and 8) we are working towards, and the associated key actions. Workforce Development, Collaboration & Wellbeing Outcome 7: A confident, compassionate, and trauma-informed workforce that provides high-quality, person-centred support for individuals and families affected by substance use Outcome 8: Members of the workforce supporting people impacted by substance use work as part of a strong multi-agency collaboration and are supported with their own wellbeing and continuous learning. Key actions Enhanced workforce capability: • Staff are supported, alongside their professional and clinical qualifications, to develop the knowledge and skills in line with consistently demonstrate the core competencies outlined in the Drugs and Alcohol Workforce Knowledge and Skills Framework17. Improved quality of care: • Workforce support and development to help ensure individuals who use substances receive effective, person-centred, and trauma-informed support, leading to improved engagement and outcomes. Sustainable workforce wellbeing: • Ensure staff feel supported in their roles through regular supervision, access to trauma-informed resources, and opportunities to maintain their own wellbeing. 17 Drugs and Alcohol Workforce Knowledge and Skills Framework 68
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PUBLIC INFORMATION • Support staff wellbeing and support around vicarious trauma by creating spaces for shared learning, mutual support, and open dialogue, especially for those with lived experience. Learning and development: • Workforce members have equitable access to current, relevant, and high- quality learning opportunities through the Prevention and Service Support Team (PSST) and other relevant training sources. • Support knowledge and skills through more multi-agency joint training, to make staff more aware of the different roles and responsibilities of people that are operational and on the ground. Trauma-informed approaches: • Staff are helped to apply trauma-informed approaches in their daily work, supported by the National Trauma Transformation Programme18 learning resources, contributing to safer and more supportive environments. • Trauma-informed workplaces developed to help reduce stigma and enable individuals in recovery to seek support without fear of judgement or job loss. 18 National Trauma Transformation Programme 69
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PUBLIC INFORMATION Community Development & Support Actions to reduce poverty and address inequalities, including support for education and employment, are all key to tackling alcohol and drug harms which are closely linked to social and health inequalities (as outlined in the Introduction). Our partnership work related to community development and support is focused on building on the assets and strengths of our communities, fostering connections, and supporting people in recovery. Our partnership work focused on community development and support encompasses the following main areas of activity, including the outcome (Outcome 9) we are working towards, and the associated key actions. Community & Recovery Support Initiatives Outcome 9: Connected and compassionate communities where people are supported to grow, contribute, and thrive together, through shared resources, inclusive opportunities, and strong local partnerships Key actions • Support individuals in recovery to gain confidence, skills, and qualifications through tailored educational opportunities, such as college courses designed specifically for their needs. • Develop targeted youth work programmes that support resilience, healthy choices, and positive community engagement. • Ensure people have access to holistic community support services that address a range of social, emotional, and practical needs. • Develop and sustain initiatives that ensure people impacted by alcohol and drug experiencing poverty are supported in meeting their basic needs, reducing inequality, and promoting dignity and stability. • Individuals are supported to access training, volunteering, and employment opportunities, enhancing their economic independence and self-worth. • Recovery groups/activities, drop-ins, and club sessions are developed across North Ayrshire to foster a sense of community, reduce isolation, and promote mutual support • People with lived/living experience are supported to access meaningful roles in volunteering, promoting inclusion, purpose, and peer-led support. 70
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PUBLIC INFORMATION Housing Housing is a basic need. Addiction often leads to people presenting as homeless. It is crucial to enable people impacted by alcohol and drug harms to access quality housing that meets their needs (and the needs of their family) and supports long- term health and wellbeing. People who are experiencing high need related to addiction, and sometimes also contact with the justice system (see Justice priority below), require support to access housing and homelessness services and to be linked to other services. Strong partnership working and a ‘no wrong door’ approach (‘ask and act’) is key to addressing homelessness and progressing prevention. Our partnership work focused on housing encompasses the following main areas of activity, including the outcomes (Outcomes 10 and 11) we are working towards, and the associated key actions. Housing & Recovery Outcome 10: People impacted by addiction, homelessness, and/or the justice system experience stable transitions, reduced reoffending, and improved wellbeing, supported by strong partnerships, integrated services, and innovative housing solutions. Key actions • Ongoing collaboration between NADARS and housing services to support individuals transitioning from residential rehab. • Joint work with Justice Services and a dedicated housing officer to support people leaving prison and to reduce reoffending. • People impacted by addiction are linked to housing and other relevant services to ensure holistic support. • Individuals in recovery or leaving prison are signposted and supported to services which ensure smooth transitions into stable housing, reducing risk of relapse or reoffending. • Reducing the risk of homelessness by improving access to appropriate accommodation options. • Strong cross-sector collaboration to ensure people receive timely, coordinated support. 71
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PUBLIC INFORMATION Housing Pathway Improvement Outcome 11: The risk of homelessness and relapse is reduced by providing the right support at the right time, with a strong focus on early support and prevention Key actions • Investment in training for housing support workers to help increase understanding of addiction, recovery and trauma, and to facilitate trauma-informed and person- centred approaches that provide support for individuals’ specific, circumstances and needs. • Develop trauma-informed approaches to housing options, including gender- specific and privacy-respecting environments to best support people on their recovery journey. • Prioritise local placements to maintain continuity of care and community support. • Embed lived experience in service design and evaluation to ensure relevance and dignity. Justice Our partnership work encompasses all points of the criminal justice system to help address alcohol and drug issues, and to develop and enhance recovery opportunities for all people involved with the justice system. Our partnership work focused on justice encompasses the following main areas of activity, including the outcome (Outcome 12) we are working towards, and the associated key actions. Criminal Justice System & Recovery Outcome 12: Individuals who have contact with the justice system experience compassionate support for their recovery and continuity of care, from co-ordinated services that are trauma-informed and gender-informed, fostering their long-term rehabilitation and wellbeing Key actions Improved continuity of care: • Individuals receive consistent addiction treatment and recovery support during and after custody. ADP and Community Justice Partnership will work together to promote pathways to people within custody suites and to people being liberated from prison back to North Ayrshire. Reduced reoffending: 72
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PUBLIC INFORMATION • Continued investment in Recovery Development Workers within Community Justice Services to promote recovery and housing pathways to reduce the likelihood of returning to prison. • Develop a drop-in hub specifically for people being liberated from prison to enable them to access resources and support from one place. Gender-informed justice responses: • Women in the justice systems are linked with appropriate support services in North Ayrshire to receive equitable, trauma-informed, and family-sensitive support. Enhanced multi-agency coordination: • Safeguarding and justice services work collaboratively to address complex needs involving substance use and domestic abuse. Increased engagement in recovery: • People subject to Drug Testing and Treatment Orders (DTTOs) are actively supported through structured recovery programs, improving outcomes and compliance. 73
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PUBLIC INFORMATION Finance Alcohol and Drug Partnerships coordinate local use of earmarked and additional resources. Scottish Government funding to support national alcohol and drugs strategic objectives is delegated in its entirety for disbursement per local ADP Strategic Plans. As ADPs are not incorporated legal entities, Scottish Government funding is provided, via NHS Boards, to Integration Authorities (IAs), to allow accountable local commissioning and distribution. In North Ayrshire, ADP finances are managed through the ADP Finance and Quality Assurance Group. The group have oversight over ADP budgets, distribution of funding, and monitoring and evaluating the impact of funding provided. Core Monies 45% DDTF 3% National Mission 38% Residential Rehab 0% Whole Family Approach 3% Outreach 1% Stabilisation Fund 5% Lived and living experience 2% Mat Standards -3% 25/26 ADP Initial Projections 74
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Integration Joint Board 12th February 2026 Subject: Participation and Engagement Strategy 2026-2030 Purpose: This report presents an updated Participation and Engagement Strategy for 2026-2030 and is seeking:- • Approval Recommendation: Approve the updated strategy, replacing the Participation and Engagement Strategy for 2022-2025, to support the delivery of the refreshed Strategic Plan for 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 Integration Joint Board agreed its refreshed Strategic Plan on the 11th of December 2025, which updates the HSCPs priorities for delivery and long-term planning from the 1st of April 2026 to the 31st March 2030. This updated Participation and Engagement Strategy has been developed to support the delivery of the refreshed Strategic Plan’s Strategic Outcomes and outline the HSCPs approach to ensuring the participation of individuals, carers, staff, partners, and communities in shaping health and social care services. 1.2 The strategy builds on the previous 2022–2025 framework and reflects national guidance, local insights, and statutory duties. It was developed by examining the previous engagement carried out by the HSCP and identifying any gaps and priorities going forward, and it outlines an action plan for the 4-year period it covers. 1.3 The Participation and Engagement Strategy was developed with the support of Heads of Service and Senior Managers across the HSCP and was endorsed by the Strategic Planning Group on the 26th of November 2025. Agenda Item 7 75
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1.4 Appendix 1 presents the final Participation and Engagement Strategy 2026-2030 which will be in place from the 1st of April 2026. 2. BACKGROUND 2.1 Engagement is a statutory duty under the Public Bodies (Joint Working) (Scotland) Act 2014, as well as the Community Empowerment (Scotland) Act 2015.COSLA published updated Planning with People Community Engagement and Participation Guidance in 2024, which outlines that ‘Individual engagement projects must be planned as part of an organisation's wider engagement strategy. It is important that community groups are involved from the earliest opportunity, and throughout the development, in the planning and decision-making process for service change.’ 2.2 The HSCP’s previous Participation and Engagement Strategy was in place from 2022- 2025 and delivered significant progress, including the development of the Care Improvement Network, a revision of the Locality Planning Process, expanded digital engagement, and diversifying the engagement methods used by the Partnership. 2.3 The updated Participation and Engagement Strategy for 2026-2030 was developed between August 2025 and January 2026. It consisted of: • Assessment of previous strategy: The commitments made in the 2022- 2025 Participation and Engagement Strategy were considered, to allow the updated strategy to reflect what was achieved and build upon our approach. • Policy Review: National legislation, statutory guidance, and best practice frameworks were reviewed to ensure that statutory participation requirements were considered, and best practice was reflected. It also considered specific groups such as service user groups or seldom heard groups to ensure considerations were included in the approach. • Engagement Insights: All engagement evidence gathered between 2022 and 2025 across all HSCP services were gathered and analysed to note methods, strengths, gaps and impact. This supported the identification of new priorities and principles, and actions that would build on previous lessons learned. • Engagement Survey: In 2024, the Partnership focused it's What Matters to You? campaign on public engagement, asking individuals how they prefer to be involved and what matters most when sharing their views with us. Key findings highlighted a strong preference for digital engagement (e.g. online surveys, email updates), regular consultation, and clearer communication about how feedback is used. • Service input: Services across the HSCP were contacted in August 2025 and asked to complete an engagement activity template for 2025 in order to gather information about who had been engaged with, how it was carried out, and what the outcomes or outputs were, as well as anything currently being planned. 76
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• Analysis: Using the gathered evidence, new Principles of engagement were identified as well as Partnership wide priorities which support the implementation of the Strategic Outcomes identified within the refreshed Strategic Plan for 2026-2030. The draft Plan was presented to the Strategic Planning Group on the 26th of November 2025. The refreshed strategy supports the delivery of the refreshed Strategic Plan 2026–2030 Strategic Priorities: • Supporting the Improvement of Population Health • Addressing the Changing Needs of an Ageing Population • Tackling the Root Causes of Health Inequality 3. UPDATED Strategy 2026-2030 3.1 The Participation and Engagement Strategy 2026-2030 outlines a vision for a health and social care system where every voice matters, and every decision considers the lived experience of North Ayrshire’s communities. It identifies a new set of Principles of Engagement, which guide how we plan to listen, involve and act when engaging with our communities: • Equity: We actively seek to remove barriers to participation, ensuring that seldom-heard voices are included and valued. Engagement opportunities will be designed to be accessible, inclusive, and responsive to diverse needs and experiences. • Transparency: We will be open about our processes, decisions, and limitations. Communities will see how their input has shaped outcomes, with clear feedback loops and honest communication about what can and cannot be changed. • Collaboration: We will work in partnership with individuals, groups, and organisations, recognising the expertise that comes from lived experience. Co- design and shared decision-making will be central to how we plan and improve services. • Respect: We will treat all participants with dignity, recognising the time, insight, and emotional labour involved in sharing experiences. We will foster safe spaces for dialogue and uphold confidentiality and consent throughout. • Continuous Improvement: We will learn from every engagement, adapting our approaches based on feedback and evidence. We will monitor and evaluate our practices to ensure they remain meaningful, effective, and aligned with best practice. 3.2 The principles of engagement will guide the way we approach engagement to deliver our new Priorities for 2026-2030. 77
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The 6 new priorities for Participation and Engagement outlined within the new Strategy, are: • Build a Culture of Engagement – embedding engagement responsibilities and good practice across teams and governance structures. • Strengthen Inclusive Engagement – reaching seldom-heard groups and ensuring culturally appropriate formats. • Improve Communication and Feedback Loops – closing the loop with clear updates and accessible feedback channels. • Enhance Locality-Based Engagement – aligning with locality planning and supporting tailored, place-based approaches. • Increase Accessibility and Flexibility – offering varied formats and scheduling to meet diverse needs. • Monitor, Evaluate and Improve – using consistent reporting and shared learning to refine our methods. 4. DELIVERY AND MONITORING 4.1 An action plan has been included in the strategy, aligned to 6 newly identified priorities for participation and engagement. These show what the strategy plans to achieve over the plan period, including both practical actions such as the development of toolkits and digital spaces for sharing engagement data, and mainstreaming actions such as considering how seldom-heard groups are considered in the design process of engagement planning. 4.2 The Strategy highlights our commitment to strengthening our key continuous engagement forums, such as The Care Improvement Network, Locality Planning Model, What Matters to You? and Care Opinion, as well as identifying priority areas for strengthening engagement over the course of the strategy. 4.3 It also outlines how engagement will be built into the implementation of the Strategic Outcomes Workstreams, as identified in the Refreshed Strategic Plan 2026-2030. 4.4 Finally, the strategy outlines how success will be measured. This includes: • Development of a reporting template to allow engagement to be captured and analysed on an ongoing basis. • Implementation of an annual engagement report which will disseminate insights and good practice across the partnership. • Regular monitoring via the Strategic Planning Group, which will allow partnership engagement work to be carried out through members. 78
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5. PROPOSALS 5.1 It is recommended that IJB: • Approve the refreshed Participation and Engagement Strategy, which supports the delivery of the Refreshed Strategic Plan, from 2026-2030 • Note the activity to be carried out following approval of the draft plan regarding delivery and monitoring, including the development of an Annual Engagement Report • Agree the Plan will be monitored regularly via the Strategic Planning Group. 5.2 Anticipated Outcomes The alignment of the Participation and Engagement Strategy 2026-2030 to the Refreshed Strategic Plan Caring Together 2026-2030 ensures that individuals, service-users, carers and staff are involved in the long-term planning of local services in terms of anticipated future health and care needs of the population. The new Principles for Engagement aim to commit to a standard of engagement across the HSCP that will allow teams to consider how they are engaging with their communities or service-users and ensuring a standardised approach to participation across the partnership. The new Priorities outline how we plan to improve our engagement processes and ensure more people are able to be involved in a wider range of activities to be included in the decision-making process across the partnership The Action Plan outlines what we intend to deliver over the 4 years which will keep the HSCP accountable to our communities as well as outline the opportunities that people will have to be involved. This action plan will monitored via the Strategic Planning Group to ensure that delivery is carried out and our new Annual Engagement Report will highlight Best Practice examples and continue the momentum of engagement across the Partnership. It is anticipated that the new Participation and Engagement strategy will increase transparency, focus engagement on areas that are most needed, encourage increased participation and awareness of participation opportunities, and foster good relationships with North Ayrshire communities, HSCP services-users and staff, and local carers, families, and other stakeholders. 5.3 Measuring Impact The Action Plan will be monitored via the Strategic Planning group to ensure accountability, and activity will be reported via an Annual Engagement Report. Good practice will also be shared within the IJBs Annual Performance Report. 79
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6. IMPLICATIONS 6.1 Financial The Participation and Engagement Strategy will support the delivery of the HSCPs Strategic Plan, which considers the HSCPs medium term financial outlook and recognises the difficult financial operating context. Budgets have been considered when outlining the Action Plan to ensure the actions are able to be carried out within existing engagement or team budgets. 6.2 Human Resources The Strategy outlines how we plan to engagement with staff as well as communities. 6.3 Legal Engagement is a statutory duty upon Local Authorities, Health Boards and IJBs and Planning for People Statutory Guidance outlines that organisations should have their own Engagement Strategies. 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 Strategic 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 and the Participation and Engagement Strategy aims to support this work by planning and facilitating engagement to enhance this planning. 6.6 Community Wealth Building None. 6.7 Key Priorities The Strategy supports the delivery of the 3 new Strategic Outcomes of the 2026-2030 Strategic Plan. 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. 80
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Senior Managers were then asked to complete and engagement template outlining their activities already carried out or planned for 2025. Between these activities, engagement gaps and strengths were identified. The HSCP carried out What Matters to You? engagement in 2024 asked people how they wanted to be engaged in future, which supported the development of priorities and actions in the plan. Strategic Planning Group was presented with the draft Strategy on the 26th of November 2025, following which Senior Managers were asked for feedback on the draft plan between November 2025 and January 2026, and PSMT was presented with the draft plan in January 2026 to enable any last comments to be provided. Caroline Cameron, Director Principal Manager, Planning, Performance and Transformation: Stuart MacMillan Author: Seony Ross, Team Manager Strategic Planning and Equalities, seonyross@north-ayrshire.gov.uk Appendices • Participation and Engagement Strategy 2026-2030 • ECRIA for the Participation and Engagement Strategy 81
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1 North Ayrshire Health and Social Care Partnership Participation and Engagement Strategy 2026-2030 82
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2 Contents Foreword ................................................................................................................. 3 Introduction ............................................................................................................ 4 Purpose of Strategy .................................................................................................. 4 Policy and Legislative Context ................................................................................... 5 Statutory Duties and National Requirements .......................................................... 6 Inclusive, Rights-Based Engagement ...................................................................... 6 Engaging Seldom Heard Groups ............................................................................ 7 Continuous Engagement and Feedback Loops ....................................................... 7 Accessible Communication and Empowerment ..................................................... 7 Local Alignment ................................................................................................... 8 Engagement Insights ................................................................................................ 8 How We Have Engaged 2022-2025 ......................................................................... 8 Health and Community Care Service ................................................................ 10 Children, Families and Justice Service .............................................................. 11 Mental Health Service ..................................................................................... 11 Professional Standards .................................................................................... 13 Planning, Performance and Transformation Service ........................................... 13 Commissioning Team ...................................................................................... 13 Key Engagement Methods ................................................................................... 14 Groups Reached................................................................................................. 16 Gaps.................................................................................................................. 17 What have you told us about Engagement? .......................................................... 17 Vision and Principles .............................................................................................. 19 Our Principles of Engagement .......................................................................... 19 Priorities ................................................................................................................ 20 Priority Engagement to Deliver the Strategic Plan ...................................................... 21 Action Plan ............................................................................................................ 24 Measuring Success ................................................................................................ 27 Glossary of Terms .................................................................................................. 28 Appendix ............................................................................................................... 29 Appendix 1: Policies Reviewed ............................................................................. 29 83
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3 Foreword At North Ayrshire Health and Social Care Partnership, we believe that the voices of our communities are not just valuable, they are vital. This Participation and Engagement Strategy sets out our commitment to listening, learning, and acting together with the people we serve. It is both a roadmap and a promise to embed meaningful involvement across all aspects of our work, ensuring that services are shaped by those who use them. We are proud to build on the principles of Planning with People and the Health and Social Care Standards, translating national guidance into local action. This strategy reflects the insights of individuals, families, carers, staff, and partners who have generously shared their experiences and ideas. Their contributions have helped us identify what matters most and how we can work better together. Participation is not a one-off event, it is a continuous, evolving relationship. Whether through our Locality Planning model, service redesign in our Transformation agenda, or everyday conversations, we are committed to creating spaces where people feel heard, respected, and empowered. We recognise that some voices are seldom heard, and we are determined to change that by removing barriers and fostering trust. I want to thank everyone who has contributed to this strategy and who continues to champion inclusive engagement across North Ayrshire. Together, we can build a health and social care system that is transparent, responsive, and rooted in the lived realities of our communities. Caroline Cameron Caroline Cameron, Director, North Ayrshire Health and Social Care Partnership, Chief Officer, North Ayrshire Integration Joint Board 84
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4 Introduction North Ayrshire Health and Social Care Partnership (NAHSCP) is one of 31 Partnerships established under the Public Bodies (Joint Working) (Scotland) Act 2014. This legislation introduced integrated health and social care partnerships across Scotland to reduce organisational barriers and improve outcomes for people receiving care and support. Each partnership is responsible for delivering services delegated by their Local Authority and regional Health Board, in line with a locally agreed Integration Scheme. NAHSCP brings together services from North Ayrshire Council and NHS Ayrshire and Arran to provide joined up, person centred support for individuals, families and communities across North Ayrshire. Our integrated approach enables us to respond more effectively to people’s needs, promote wellbeing and support people to live independently. We are committed to working in partnership with our communities, staff, carers and stakeholders to shape services that reflect what matters most to the people who use them. Participation and engagement are central to this commitment. By listening to lived experience and involving people in decision making, we aim to build services that are inclusive, transparent and continuously improving. This strategy outlines how we will strengthen participation and engagement across our HSCP services, in line with our strategic goals. It outlines our purpose, principles, and priorities, and describes how we will build on national guidance, local insights and community feedback to strengthen public involvement in health and social care planning and delivery. Purpose of Strategy This strategy defines how NAHSCP will involve individuals, communities, staff, carers, and partners in shaping the design, delivery, and improvement of health and social care services. It supports our statutory duties under the Public Bodies (Joint Working) (Scotland) Act 2014, which requires Integration Joint Boards (IJBs) to develop a Strategic Plan for the integrated functions and budgets under their control. Our strategic priorities are outlined in the refreshed IJB Strategic Plan, Caring Together 2026–2029. These are: Supporting the Improvement of Population Health Addressing the Changing Needs of an Ageing Population Tackling the Root Causes of Health Inequality 85
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5 These priorities aim to address future demand on services and the underlying causes of poor health by gathering evidence for long term planning. HSCP strategies will align with these goals, and decision-making will take these priorities and their impacts into account when implementing change. How we listen to and include people as equal partners will be key to achieving these priorities and ensuring that outcomes improve over the duration of the plan. In addition to the strategic priorities, there are six service delivery priorities that reflect how services will be designed and delivered to meet the health and care needs of our population. These are: - Prevention - Community Based Services - Life Stages - Whole Person Approach - Accessibility and Communication - Evidence and Performance These priorities are informed by data, national policy, service user engagement, and frontline insight. Each service area is responsible for embedding engagement in its planning and delivery, ensuring that participation is not sought only after decisions are made, but is a core part of how we work. A clear strategy provides a shared framework for meaningful engagement, strengthens accountability, and helps us build a culture where every voice contributes to shaping health and care services across North Ayrshire. Policy and Legislative Context To ensure this strategy reflects current expectations and delivers meaningful, inclusive engagement, a detailed review of national legislation, statutory guidance, and best practice frameworks was undertaken. This process helped identify the legal duties, strategic priorities, and quality standards that must shape how North Ayrshire HSCP involves people and communities in service planning and decision-making. The policies were analysed thematically, covering statutory participation requirements, inclusive communication, children’s rights, co-production, and community empowerment. Specialist guidance was also considered to strengthen engagement with groups who face barriers to participation, including older adults, unpaid carers, children and young people, and communities affected by poverty, discrimination, or social isolation. The policies were grouped into the following headings, and provide a baseline for our Partnership wide principles. 86
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6 This policy foundation ensures the strategy is not only compliant with national requirements but also responsive to the lived experiences of local people. It supports the delivery of North Ayrshire HSCP’s strategic priorities and national health and wellbeing outcomes through co-produced, rights-based, and continuous, engagement. A full list of policies reviewed is provided in Appendix 1. Statutory Duties and National Requirements The Partnership has a statutory participatory duty to involve a range of people in developing and delivering services. The Public Bodies (Joint Working) (Scotland) Act 2014 establishes the legal requirement for IJBs to involve service users, carers, staff and community partners in the development of the Strategic Plan and any other significant decisions affecting service delivery. This includes both permanent and temporary changes to services, even when these fall outside the scope of the Strategic Plan. The Act requires that such decisions are informed by the views of the Strategic Planning Group and wider stakeholders. The Planning with People: Community Engagement and Participation Guidance (2024), jointly issued by the Scottish Government and COSLA, reinforces this duty. It sets out expectations for early, proportionate, and ongoing engagement in all aspects of care service planning and development that fall within the scope of delegated health services. The guidance emphasises that engagement must be embedded in governance and decision-making processes, with clear evidence of how public input has influenced outcomes. The National Health and Wellbeing Outcomes further highlight the importance of participation, stating that people should have positive experiences of care and that staff should be supported to continuously improve services through engagement. Inclusive, Rights-Based Engagement The Health and Social Care Standards: My Support, My Life (2017) establish a rights- based framework for care and support. They affirm that people must be fully involved in decisions about their care, receive information in accessible formats, and be supported to participate in service improvement. These principles underpin this strategy’s commitment to inclusive, person-centred engagement, as set out in the following sections. Children’s rights are embedded through alignment with the UN Convention on the Rights of the Child (UNCRC) and the Scottish Government’s Children’s Human Rights Guidance. These frameworks require that children and young people are meaningfully involved in decisions that affect them, with appropriate support and safeguards in place. This strategy commits to using Child Rights and Wellbeing Impact Assessments 87
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7 (CRWIAs), where relevant, to ensure compliance with the UNCRC and Scottish Government guidance. The Principles of Inclusive Communication guide the HSCP in ensuring that all engagement materials and processes are accessible to people with communication support needs. This includes providing information in multiple formats and training staff to recognise and respond to diverse communication requirements. Engaging Seldom Heard Groups The Scottish Government’s Seldom Heard Groups Action Plan calls for inclusive, trauma-informed, and culturally competent engagement. It recognises that people affected by poverty, discrimination, disability, and social isolation often face barriers to participation. This strategy commits to addressing these barriers and co-producing engagement tools and service designs with people who have lived experience. The ALLIANCE Scotland Toolkit provides practical guidance for engaging structurally excluded communities. It emphasises the importance of trust-building, intersectionality, and partnership working with community organisations. These principles are reflected in this strategy’s approach to reaching underrepresented groups. The National Standards for Community Engagement offer a structured framework for planning, delivering, and evaluating engagement. They support the HSCP in ensuring that participation is inclusive, meaningful, and outcome focused. Continuous Engagement and Feedback Loops The Quality Framework for Community Engagement and Participation, developed by Healthcare Improvement Scotland and the Care Inspectorate, provides a national benchmark for assessing and improving engagement practice. It supports continuous improvement through regular self-evaluation and reporting, focusing on outcomes, process, and leadership. Planning with People reinforces the need for sustained engagement beyond one-off consultations. It requires Integration Authorities to demonstrate how engagement has influenced decisions and to maintain transparent feedback loops that show how public input has been used. Accessible Communication and Empowerment Inclusive communication is a core component of this strategy. The HSCP will apply the Principles of Inclusive Communication across all engagement activities, ensuring that information is made available in formats that meet the needs of diverse communities. This includes Easy Read, BSL, large print, and translated materials. 88
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8 The strategy also draws on guidance from Age UK and international research on engaging older adults and informal carers. These sources highlight the importance of empowering carers, volunteers, and frontline staff to shape services and contribute to continuous improvement. Local Alignment As a Community Planning Partner, North Ayrshire HSCP works collaboratively with a wide range of public sector organisations — including North Ayrshire Council, NHS Ayrshire & Arran, Police Scotland, Scottish Fire and Rescue Service, and Scottish Enterprise — to ensure that engagement is joined-up, inclusive, and responsive to community needs. We also work closely with North Ayrshire’s Third Sector Interface - Arran CVS and The Ayrshire Community Trust - to enable engagement with the local third and community sector organisations that support people in the community. Engagement activities will be aligned with both the North Ayrshire HSCP Strategic Plan and the North Ayrshire Community Planning Partnership Participation and Engagement Framework, supporting the delivery of national health and wellbeing outcomes and shared local priorities. Engagement Insights How We Have Engaged 2022-2025 Between 2022 and 2025, North Ayrshire Health and Social Care Partnership undertook a wide range of engagement activities across our core service areas. These efforts were designed to ensure that people with lived experience, carers, staff, and community partners could contribute meaningfully to service planning, redesign, and improvement. To strengthen our engagement reporting, we asked services across the Partnership to record and share their activity, helping to build organisation-wide insights. Engagement has been delivered across all our operational services — Mental Health, Health and Community Care, and Children, Families and Justice — as well as by many of our wider support teams, including Planning, Performance & Transformation, Commissioning, and Professional Standards. This section provides an overview of how engagement was delivered during this period. It outlines the approaches used, key forums and networks involved, the scale and reach of activity, and the groups we connected with. It also identifies gaps and areas for improvement, helping us build a more inclusive and responsive approach going forward. Below are the commitments of our previous Participation and Engagement 2022-2025 strategy, and evidence of the Partnership delivering against these commitments. 89
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9 2022-2025 NAHSCP Participation and Engagement Strategy Commitment Evidence of Delivery Continue to develop platforms and pathways to engage that are meaningful, flexible, accessible, and open to everyone across the community. • Development and refresh of the Care Improvement Network • Launched and promoted of the Partnership Eventbrite page for public engagement opportunities • Use of multiple formats including surveys, Conversation Cafés, drop-ins, and lived experience panels • Expansion of digital and paper-based feedback options available across North Ayrshire, working in partnership with our libraries and GPs • Creation of new mental health Carers Forum • Locality Planning Microsoft Forms Survey which remained open all year round Continue to develop our presence on social media and develop relatable, informative content. • Increased use of the NAHSCP Facebook page to promote surveys, events and updates on a wide range of services and public health topics, including targeted campaigns during WMTY 2024 and locality engagement periods • Increased cross promotion of health and social care engagement opportunities, service information and public health messaging on partner or service specific Facebook accounts - including NAC, Youth Services, Housing, Corporate Parenting, Community Link Workers and a range of NHS accounts - to extend our digital reach. • Continued to grow our NAHSCP YouTube channel by adding video content on a range of topics and services • Launched a dedicated Fostering website in Partnership with CAN (Council Advertising Network) in November 2024 to drive Foster Care recruitment. • Gained access to post content on a wide range of Child Protection themes directly onto all NAC Youth Services platforms, allowing us to digitally reach a demographic that is difficult to reach on Facebook or X. • Continued promotion of Care Opinion on the NAHCP Facebook page to encourage anonymous feedback, both positive and negative, through the platform. 90
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10 Work closely with our service users, staff, locality networks, third sector organisations and community partners to ensure that we are working together on shared priorities. • Refreshed Locality Planning Model with biannual Locality Conversations • HSCP representation on CPP Locality Partnerships • Collaboration with third sector partners on targeted engagement e.g. Equalities • The development of Pan-Ayrshire suicide prevention campaigns for social media to ensure consistent messaging across all Ayrshire partners Develop clearer governance between the Strategic Planning Group and Locality Planning Structures • Strategic Planning Group now provides governance for Locality Planning • Locality Conversation feedback formally escalated to SPG and IJB for action Health and Community Care Service The Health and Community Care Service has delivered a range of engagement activities, including drop-in events, online and paper surveys, co-design workshops, and 1:1 sessions. These engagements have involved: - Service Users and the General Public – Contributing to the option appraisal for Montrose House on the Isle of Arran and shaping proposals for a new day care service. - Individuals with Lived Experience of Neurological Conditions, and their Families and Carers – Helping to establish a care network, identify priority areas for support, and share learning. Participants also co-created a patient story for use in conferences and training. Feedback informed improvements across wards in line with national guidelines, including the creation of a care network and the introduction of ward-based exercise classes. - Women Experiencing Substance Misuse – Supporting a new funding bid and identifying potential support from occupational therapy services. - Physiotherapy Teams – Providing service feedback and contributing to outcome development across rehabilitation centres. - Augmentative and Alternative Communication (AAC) Staff – Assessing staff knowledge and skills to inform the development of a service plan. In addition to this targeted engagement, a significant number of information sessions and engagement scoping exercises have been carried out in alignment with the Collaboration for Health Equity in Scotland (CHES) Pilot, of which North Ayrshire is a participating area. 91
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11 Children, Families and Justice Service Our Children, Families and Justice Service has engaged with a wide range of service users throughout the duration of the previous strategy, using methods such as conferences, focus groups, workshops, and questionnaires. We have engaged with: - Care-Experienced Young People – through our Champions Boards across secondary schools, the co-development of an app for care-experienced young people and our Annual Promise Conference (which highlighted recommendations for social workers and partners on how to keep The Promise). - Parents and Carers – including those caring for children with neurodevelopmental differences, who contributed to the development of our new neurodevelopmental pathway. We also engaged with mothers involved in breastfeeding support groups to evaluate and improve our support services. - Justice-Experienced Individuals – to better understand their experiences, improve support services, track potential referrals to other services, and identify what is working well. These engagements have influenced a range of service changes, from the development of new pathways to the revision of documentation language to ensure it is more relevant and accessible to service users. In addition to planned engagement activities, the service hosts a variety of regular groups for service users, including Dad Groups for single parents with young children, Perinatal Patter groups, and breastfeeding support groups to build confidence among new mothers. For justice-experienced individuals, we offer guitar, sport, and cooking groups to support community integration and develop practical skills. Mental Health Service Our Mental Health Service has undertaken significant engagement activity, not only within North Ayrshire but across Ayrshire, as the Lead Partnership for mental health services for Ayrshire and Arran. Engagement methods have included focus groups with service users, surveys, in-person and telephone interviews, stalls, and co-design workshops. These activities have involved: - Service Users with Co-Occurring Mental Health and Addiction Issues – To identify service improvement areas for individuals experiencing both mental health, alcohol and/ or drug issues, accessing Health and Social Care Services and how an agreed pathway of support should ensure the right care, at the right time, by the right person. - Service Users of the Alcohol and Drug Partnership (ADP) – To contribute to the development of the ADP Strategic Plan and co-develop harm reduction packs. - Young People – To raise awareness and education around substance use and identify emerging risks, or areas of support. 92
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12 - People with Learning Disabilities – To co-create a mutual learning tool in the form of a game, promoting digital inclusion and technology use, and to inform “What Makes a Good Life”, part of the Learning Disability (LD) Learning Plan. - People in the Gypsy/traveller community – engagement with members of the community and partners to develop a culturally appropriate mental health and suicide prevention leaflet to improve engagement in the future. - Family Carers Supported by North Ayrshire Intensive Support Team and wider Unscheduled Care Mental Health Service – To inform a learning report and guide future service development. - Learning Disability Staff – To contribute to the options appraisal process for the future of LD assessment and treatment services. - Children and Families with Disabilities Staff and Adult Social Work – To support service redesign in relation to service user transition from children to adult services. - Carers and Families of Individuals with Lived Experience of Mental Health – To co-design a carers survey for inpatient and addiction services, streamline engagement data across Ayrshire, and establish a carers forum that regularly collects feedback for clinical teams. - ACORN Service Users and Trainees – To identify required service changes and redesign the patient leaflet, webpage, and communications. - Staff in the Adult Community Mental Health Service Unscheduled Care Team and External Stakeholders – To review service strengths and barriers, contributing to the annual service review. Feedback is shaping updates to the website, leaflets, and posters. - Potential users and staff of new and emerging services – engagement was carried out for the development or redesign of an Infant Mental Health Service, Early Intervention Psychosis Service, Perinatal Mental Health Service, and Maternity and Neonatal Mental Health Service. - Individuals with Lived Experience of Mental Health – Through an open online survey, feedback is gathered and shared with clinical teams for consideration. In addition to these engagement activities, which often inform service design and improvement, we host the North Ayrshire Mental Health Arts Festival in partnership with the North Ayrshire Council Arts and Culture team on an annual basis. The festival is run as part of the wider national programme run by the Mental Health Foundation, and features over 20 events coordinated by community groups and partners, all aimed at promoting awareness, reducing stigma, and signposting to local groups and services. 93
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13 Professional Standards The Professional Standards Service has delivered a range of engagement activities, including surveys, focus groups, lived experience panels, and events. These have involved: - Self-Directed Support (SDS) Users and Organisational Representatives – Reviewing the FAQ section of the SDS website and participating in user testing ahead of its initial launch. - Unpaid Carers and Carers Gateway – Contributing insights to shape the new Carers Strategy and streamline questions within the new Adult Carer Support Plan. - Social Workers in HSCP – Reflecting on practice and professional identity as part of World Social Work Day activities. - Individuals with Lived Experience across Services – Informing learning and development activities, training materials, and interview processes for relevant courses. In addition to targeted engagement, the Professional Standards Service also hosts regular information sessions for HSCP staff, partners, and the public. These sessions promote development opportunities, recruitment events, and available supports offered by the HSCP. Planning, Performance and Transformation Service Our Planning, Performance and Transformation Service has delivered a range of engagement activities, including Microsoft Forms surveys, Conversation Cafés, and facilitated group sessions supported by tailored facilitator packs. These activities have focused on: - Young People – As part of the Locality Planning Model, young people shared their views on what matters most in their locality, the barriers they face, and their ideas for improvement. This engagement will directly inform the HSCP Locality Plans and the refresh of the Children’s Services Plan in 2026. - Equalities Groups – Exploring the unique barriers faced by individuals with protected characteristics when accessing HSCP services. Insights from this engagement directly shaped the 2025-2029 HSCP Equalities Outcomes. Commissioning Team The Partnership Commissioning team have also engaged with service users via surveys, 1:2:1s and focus groups. Their engagement took place with: - Adult Community Support Providers and Network – Reviewing the tender process, reshaping the provider forum hosted by NAHSCP, and fostering 94
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14 collaboration to share insights, address challenges, and identify opportunities for service improvement in adult community support. - Care-Experienced Young People – Engaging young people living in our children’s houses to inform the service specification for Transitional Supported Living. Key Engagement Methods We use a range of key engagement forums and service-level activities to ensure that participation is embedded across all areas of service design, delivery, and improvement. Across our services, engagement has been delivered through a blended mix of formats, including: • Locality-based conversations across all six areas. • Surveys and feedback cards (digital and paper) for quick, accessible input • 1:1 interviews and listening events (e.g. Conversation Cafés) for personal storytelling. • Focus groups, workshops, and co-design sessions to explore ideas collaboratively. • Lived Experience Panels and Forums for ongoing dialogue and service shaping. • Creative and informal formats such as arts festivals, walking groups, and drop- ins. • Digital engagement via Teams, email, social media, and newsletters. • Communication networks to share updates and opportunities. • Public events like Mental Health & Wellbeing Connects, featuring stalls, speakers, and interactive sessions. This blended approach ensures that engagement is flexible, inclusive, and responsive to the communities we serve. Locality Planning Model Locality Planning is a core engagement mechanism that enables communities to shape services based on local needs and priorities. Each locality hosts scheduled periods of Locality Conversations where members of the community can share their views, raise concerns, and help set priorities for service improvement. These conversations are designed to be inclusive, place-based, and part of an ongoing dialogue that builds trust, strengthens relationships, and gives opportunity for discussion. Feedback from Locality Conversations is reviewed by the Strategic Planning Group and may be escalated to the IJB for action. This ensures that local voices directly inform strategic decision-making and service development. 95
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15 Insights gathered through these conversations are used to inform service delivery and will support the development of Locality Plans for each area, helping the Partnership respond to the unique needs, challenges, and opportunities within different geographic communities. These plans will guide service design and improvement at a local level, ensuring that resources are targeted where they are needed most. Care Improvement Network The Care Improvement Network is a flexible engagement platform that enables individuals, carers, and community members to share their views in ways that suit them. Participants can engage through online meetings, phone calls, face-to-face discussions, or surveys, depending on their preferences. By joining the Network, people can indicate which service areas matter most to them— such as adult health and community care, alcohol and drug services, or justice services—and receive tailored updates about opportunities to get involved. Communications typically include links to upcoming events, consultations, and feedback channels, allowing participants to choose how and when they engage. The Partnership continues to promote and expand the Care Improvement Network, encouraging services across NAHSCP to use it as a core tool for inclusive and responsive engagement. What Matters to You? (WMTY) What Matters to You? is a national initiative that encourages meaningful conversations between health and social care services and the people they support. North Ayrshire HSCP has embedded WMTY into its strategic engagement approach since 2017, using it to gather insights that shape service design, engagement processes and improvement. In 2024, the Partnership focused its WMTY campaign on public engagement, asking individuals how they prefer to be involved and what matters most when sharing their views with us. Key findings highlighted a strong preference for digital engagement (e.g. online surveys, email updates), regular consultation, and clearer communication about how feedback is used. These insights directly informed the development of this Participation and Engagement Strategy. WMTY is now used as a continuous engagement tool across the Partnership. We plan to build on the national initiative by collecting feedback throughout the year across all service areas, showcasing how we listen, respond, and act on what matters most to our service users. Care Opinion Care Opinion is an independent online platform that allows people to share their experiences of health and social care services anonymously. North Ayrshire HSCP uses 96
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16 Care Opinion as a key engagement tool to gather real time feedback from service users, carers, and families. It provides a transparent and accessible way for individuals to tell their stories, both positive and negative, and for our services to respond publicly. By monitoring and responding to posts on Care Opinion, the Partnership can identify areas for improvement, celebrate good practice, and demonstrate how feedback is being used to shape service delivery. It also supports our commitment to continuous improvement and closing the feedback loop. Groups Reached Our engagement activity has included a wide range of individuals and communities including: 97
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17 Gaps Despite broad engagement, analysis has identified several underrepresented groups and areas where engagement needs to be strengthened: Priority groups for strengthening engagement: • People with lived experience of poverty or financial exclusion • People with long-term conditions (noted as needing deeper engagement) • Justice service users (limited direct engagement) • Digitally excluded individuals • Homeless individuals and those without fixed addresses (limited direct engagement) • People with physical or ‘invisible’ disabilities (limited direct engagement) • Those with cultural barriers E.g. Ethnic minority communities, Trans and nonbinary individuals, those with low literacy / non-native English speakers (limited direct engagement) Priority areas for strengthening engagement: • Health and Community Care services • Justice services • Financial inclusion and self-directed support services (e.g. Money Smart, SDS navigation) • Transitions between child and adult services, and post-discharge pathways in mental health These gaps will be addressed through targeted outreach embedded in this strategy. What have you told us about Engagement? As highlighted above, the What Matters to You? engagement in 2024 asked people how they wanted to be engaged in future. Although most responses were received digitally and therefore there may be slight bias towards those looking for digital opportunities, the surveys were all available across local libraries for anyone looking to participate that did not have digital access. Across all engagement activities, several consistent themes have emerged: • People want to be heard: 89% of respondents to the 2024 What Matters to You? survey said it was “very” or “extremely important” to have a say in decisions about health and social care. • Digital engagement is preferred: Online surveys, email newsletters, and social media were the most popular formats, though many still value face-to-face options. 98
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18 • People want regular, not one-off, engagement: Nearly half of respondents preferred to be consulted “a few times a year.” • Clarity and transparency matter: Respondents asked for clearer information about how changes will affect them, better promotion of engagement opportunities, and visible follow-through on feedback. • Accessibility is key: There is a need for more inclusive formats, including translated materials, Easy Read, and alternative communication methods. • People want deeper involvement: Many expressed an interest in going beyond surveys—participating in service reviews, co-design, and strategic planning. • Trust is built through action: Respondents emphasised the importance of meaningful engagement that leads to real change, not tokenistic consultation. These insights have directly shaped the development of this strategy and will continue to inform how we design, deliver, and evaluate engagement across the Partnership. 99
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19 Participation & Engagement Strategy 2026-2030 Vision and Principles Our vision is for a health and social care system where every voice matters, and every decision considers the lived experience of North Ayrshire’s communities. Our Principles of Engagement We commit to engaging with our communities through the following principles, which guide how we listen, involve, and act: Equity We actively seek to remove barriers to participation, ensuring that seldom-heard voices are included and valued. Engagement opportunities will be designed to be accessible, inclusive, and responsive to diverse needs and experiences. Transparency We will be open about our processes, decisions, and limitations. Communities will see how their input has shaped outcomes, with clear feedback loops and honest communication about what can and cannot be changed. Collaboration We will work in partnership with individuals, groups, and organisations, recognising the expertise that comes from lived experience. Co-design and shared decision-making will be central to how we plan and improve services. Respect We will treat all participants with dignity, recognising the time, insight, and emotional labour involved in sharing experiences. We will foster safe spaces for dialogue and uphold confidentiality and consent throughout. Continuous Improvement We will learn from every engagement, adapting our approaches based on feedback and evidence. We will monitor and evaluate our practices to ensure they remain meaningful, effective, and aligned with best practice. 100
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20 To guide our approach, we will use the ladder of participation to reflect the different ways we involve people in shaping services. This model illustrates a progression from ‘doing to’ and ‘doing for’ towards ‘doing with’, where co-design and co-production become central. While much of our current practice sits within the ‘doing for’ space, such as informing and consulting, our ambition is to move further up the ladder. By embedding co-production into our engagement strategy, we aim to create opportunities for communities and services to work together as equal partners—designing, testing, and delivering change. This shift is not just structural but cultural, recognising the value of lived experience and local assets in improving health and social care outcomes. Priorities As a result of the review of the legislative landscape and the engagement work undertaken by North Ayrshire Health and Social Care Partnership during the previous strategy period, the following section identifies our priority areas, which are underpinned by our Principles of Engagement outlined above. 101
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21 These priorities provide a clear framework for embedding meaningful participation across all service areas. They reflect our commitment to ensuring that engagement is consistent, inclusive, and impactful — and that the voices of people with lived experience are central to how we plan, deliver, and improve services. The six Partnership priorities are: • Build a Culture of Engagement – embedding engagement responsibilities and good practice across teams and governance structures. • Strengthen Inclusive Engagement – reaching seldom-heard groups and ensuring culturally appropriate formats. • Improve Communication and Feedback Loops – closing the loop with clear updates and accessible feedback channels. • Enhance Locality-Based Engagement – aligning with locality planning and supporting tailored, place-based approaches. • Increase Accessibility and Flexibility – offering varied formats and scheduling to meet diverse needs. • Monitor, Evaluate and Improve – using consistent reporting and shared learning to refine our methods. Each priority is supported by practical actions which are set out in the Action Plan. Priority Engagement to Deliver the Strategic Plan Effective delivery of the Strategic Plan 2026–2030 will rely on strong, inclusive engagement with people and communities across North Ayrshire. This section outlines how engagement will support the delivery of three strategic priorities: SP1: Supporting the Improvement of Population Health SP2: Addressing the Changing Needs of an Ageing Population SP3: Tackling the Root Causes of Health and Care Inequality SP1: Supporting the Improvement of Population Health This priority aims to tackle the drivers of ill health and support the improvement of population health, which could in turn decrease demand for health and care services. A strategic approach to supporting the improvement of population health will consider things like maternal and infant health, population mental health and wellbeing outcomes, healthy and harmful activity, and brain health. Engagement will be a key mechanism of this delivery process and priorities for engagement to support this workstream will include: 102
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22 • Working with families to identify behaviours that support infant health and how to support improved outcomes, such as breastfeeding rates, child healthy weight and immunisations. • Engaging communities about barriers to engaging in healthy behaviours such as balanced diet and exercise and working to use feedback to make improvements to encourage more preventative healthy activity. • Engaging with service users of the addictions service as well as those engaged with the Alcohol and Drug Partnership and using feedback to inform service improvement. • Working with communities to identify ways to promote improved population mental health and wellbeing. SP2: Addressing the Changing Needs of an Ageing Population This priority aims to address the shifting demographics with a higher proportion of older people and the impacts this may have on health and care services, such as more long- term conditions and increased demand for care services. A strategic approach to addressing the changing needs of an ageing population will consider things like frailty, mobility and balance in older people, older carers and staff, care at home and in the community. Engagement will be a key mechanism of this delivery process and priorities for engagement to support this workstream will include: • Prioritising engagement with older people, including gathering feedback which could inform future care needs. • Carrying out engagement with service users, including care at home and care home services, to understand current service, challenges, and opportunities for improvement. SP3: Tackling the Root Causes of Health and Care Inequality This priority aims to tackle the poorer health and care outcomes experienced locally through identifying and tackling the root causes, particularly the impact that poverty and deprivation can have on outcomes. A strategic approach to tackling the root causes of health and care inequality will consider things like the local impacts of poverty on health and care outcomes, the link between poverty, care experience, and child protection, and the experiences of vulnerable groups. Engagement will be a key mechanism of this delivery process and priorities for engagement to support this workstream will include: 103
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23 • Engagement for 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. • Working with service users of financial inclusion services to understand their needs and how our services could provide further support or links to other services. • Engaging with vulnerable groups about the targeted support they receive and where this could be strengthened. 104
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24 Action Plan This Participation and Engagement Strategy outlines the key areas of focus and engagement requirements to ensure that participation is not only meaningful but also accountable. This action plan outlines how we will deliver our priorities for 2026-2030, ensuring that engagement drives better outcomes for communities across North Ayrshire. Priority Actions 2026-2030 Build a Culture of Engagement Develop a suite of engagement guidance and templates for the HSCP to support teams to implement engagement exercises with service-users Embed engagement into the delivery of the Strategic Priorities workstreams outlined in the refreshed Strategic Plan 2026-2030 Develop a new framework to embed WMTY engagement through our services, including: - The development of toolkits to support staff to deliver, record and feedback engagement - Additional support that may include promotional materials and facilitation - A regular report for WMTY day which will highlight how teams have implemented WMTY and how this strengthens person-focussed care Reinvigorate the Care Improvement Network, developing a communications plan to encourage people to join and participate in engagement, and promote internally as a tool for gathering feedback Promote Care Opinion as a way for service users to provide feedback to our services, and ensure feedback and responses are shared through the partnership for learning opportunities Consider how complaints and compliments that are shared with the HSCP are being used to improve or influence our services, and how this could be used to inform service improvement Carry out engagement with groups and services identified as gaps Create and promote an Engagement SharePoint which centralises existing engagement reports and templates for staff to use Strengthen Inclusive Engagement Carry out engagement that will support the delivery of our Equality Outcomes 2025-2029 with priority groups and actions identified within the Outcomes Plan Consider how seldom-heard groups (e.g. care-experienced, gypsy travellers, rural residents, older adults) are currently being engaged and ensure planned engagement is accessible to these groups 105
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25 Work with community representatives to ensure materials are culturally relevant and accessible Develop and distribute engagement materials in multiple languages and formats when requested (e.g. Easy Read, BSL, audio) Produce toolkits for use across the partnership to ensure planned engagement is inclusive. Improve Communication and Feedback Loops Share ‘You said, We Did’ updates with the public to inform communities of how their feedback resulted in change Provide clear summaries of engagement findings targeted to range of audiences and including key themes, direct quotes and next steps Use the Care Improvement Network to share findings and ensure anyone that participated in engagement through the network receives resulting actions Promote the use of feedback tools across our services, such as Microsoft Forms, suggestion boxes, and Care Opinion Promote all engagement opportunities through the HSCP Eventbrite page and social media. Enhance Locality-based Engagement Align engagement priorities with the Locality Planning Model, ensuring each locality has a tailored engagement calendar aligned with local needs Support locality teams to lead tailored engagement by developing templates and ensuring facilitation support Capture and share locality insights by developing a process for recording and sharing locality specific feedback Increase Accessibility and Flexibility Ensure all engagement opportunities are available in varied formats Provide support for digital participation and offer printed materials where needed Ensure paper copies of surveys are available for collection in each locality where possible, either at the local library or GPs Plan engagement activities during evenings, weekends, and in accessible venues Use pop-up stalls, community cafés, and mobile outreach to reach wider audiences Ensure public engagement information uses plain English and visual formats Monitor, Evaluate and Improve Develop and implement a partnership-wide engagement reporting template to capture purpose, reach, feedback, and impact in order to understand how engagement is impacting our services Carry out an Annual Engagement Report to showcase how we have engaged with our communities across the partnership and how and where this has led to learning and real change being implemented 106
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26 Monitor participant demographics and feedback themes from all engagement exercises carried out and use this data to identify gaps and improve future engagement 107
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27 Measuring Success To assess the impact of engagement activity across the Partnership, we will develop a Partnership Wide Engagement Reporting Template. This template will be cascaded through governance structures on a biannual basis, including the Strategic Planning Group and shared with Heads of Service and senior managers to ensure all teams have the opportunity to participate. The template will enable the HSCP to analyse engagement activity across the Partnership, identify connections and gaps, and produce a public facing Annual Engagement Report. This report will be submitted to the Strategic Planning Group, which will also review progress on the Participation and Engagement Strategy, coordinate delivery, monitor impact, and ensure a joined-up approach across services. Strategic oversight will be provided by the Integration Joint Board, ensuring that engagement remains a core priority in service planning and improvement. As outlined in the National Standards for Community Engagement and Planning with People, participation in health and social care is a continuous and evolving process. At every stage, we will work collaboratively with our communities to strengthen engagement practice—remaining responsive to what matters most to them and keeping people at the heart of what we do. We will take a transparent and reflective approach, recognising both what is working well and where improvements are needed. This will allow us to review outcomes, adapt our actions, and share learning across the Partnership and with wider stakeholders to inform and enhance future engagement activity. We will monitor a range of success indicators through our reporting template, including: • Reach and inclusion: Number and diversity of participants with specific attention to seldom heard groups. • Quality of engagement: Participant feedback on clarity, accessibility and relevance of engagement activity. • Evidence of influence: clear examples of how engagement has shaped service design, policy or decision making. • Feedback loops: Evidence that findings have been shared back with participants and communities. • Transparency and reporting: Timely publication of engagement reports, and updates to governance boards. 108
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28 Glossary of Terms • Alcohol and Drug Partnership (ADP): A multi-agency strategic group responsible for coordinating local efforts to prevent and reduce alcohol and drug-related harm. • Co-production: A collaborative approach where service users and professionals work together to design, deliver, and evaluate services. • Communities: Defined as groups of people that may or may not live in the same area, and who share common interests, concerns or identities. • EQIA (Equality Impact Assessment): A tool used to assess how policies or decisions may affect people with protected characteristics and to identify ways to mitigate negative impacts. • Equality Outcomes: Specific goals set by public bodies to advance equality and eliminate discrimination, aligned with the Equality Act 2010. • Feedback Loop: A process where participants are informed about how their input has influenced decisions or service changes. • Inclusive Communication: A practice that ensures information is accessible to all, including formats like Easy Read, BSL, large print, and translated materials. • Integration Joint Board (IJB): The statutory body responsible for planning and commissioning integrated health and social care services in North Ayrshire. • Locality Planning: A model of engagement and service planning that focuses on the specific needs and priorities of defined geographic areas, as outlined in the Public Bodies (Joint Working) (Scotland) Act 2014. • Protected Characteristics: Characteristics defined under the Equality Act 2010, including age, disability, gender reassignment, race, religion or belief, sex, sexual orientation, pregnancy and maternity, and marriage and civil partnership. • Seldom Heard Group: Communities or individuals who face barriers to participation and are often underrepresented in engagement activities. • SPG (Strategic Planning Group): A statutory group that helps develop and monitor the HSCP’s Strategic Plan. • Stakeholder: Individuals or groups that have an interest in the decisions or activities of the Health and Social Care Partnership i.e. charities, health services, service users, etc. • Strategic Plan: A long-term plan outlining the priorities and direction of North Ayrshire HSCP, guiding service design and delivery as outlined in the Public Bodies (Joint Working) (Scotland) Act 2014. • Third Sector Organisation/Partner: A nonprofit organisation. 109
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29 Appendix Appendix 1: Policies Reviewed • Public Bodies (Joint Working) (Scotland) Act 2014 • Planning with People: Community Engagement and Participation Guidance (2024) • Public Bodies (Joint Working): National Health and Wellbeing Outcomes (Scotland) Regulations 2014 • Health and Social Care Standards: My Support, My Life (2017) • Community Empowerment (Scotland) Act (2015) • National Standards for Community Engagement • The Quality Framework for Community Engagement and Participation • Principles of Inclusive Communication: An information and self-assessment tool for public authorities • Scottish Government Seldom Heard Groups Action Plan • Alliance Scotland Engaging with Seldom Heard Communities Toolkit • AgeUK Guidance for effective engagement of older people • Strategies for Engaging Older Adults and Informal Caregivers in Health Policy Development: A scoping review • A practical guide to including seldom-heard children & young people in decision- making • Taking a children's human rights approach: guidance • North Ayrshire Health and Social Care Partnership Strategic Plan (2026-30 refresh) • North Ayrshire Community Planning Partnership (CPP) Plan (2022-2030) • Noth Ayrshire Community Planning Partnership Engagement Framework • North Ayrshire’s Youth Participation Strategy 110
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Version: 7.0 North Ayrshire Council Equality & Children’s Rights Impact Assessment (Full Form) Please Note: Before you begin, is this version the most up to date? You can download the most recent version on Connects. Screenings and ECRIAs should be included with relevant Committee Reports and may be published on our website. 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. 1. General Details 1.1 Directorate/Service: HSCP: Section: Planning, Performance and Transformation 1.2 Name of Policy, Practice of Proposal being assessed: Participation & Engagement Strategy 2026–2030 This is an existing proposal (being reviewed). 1.3 List of participants in the assessment Rebecca Black 1.4 Manager responsible for the impact assessment Name: Seony Ross Designation: Team Manager, Strategic Planning & Equalities 1.5 Timetable (should be started during the development phase of the proposal) Date Assessment Started: 08 Jan 2026 Interim Review Date: 12 Feb 2026 Final sign off by Head of Service at the end of the form. 111
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Version: 7.0 2. Aims and Relevance 2.1 What is the purpose of the policy practice or proposal? The strategy sets out how NAHSCP will involve individuals, carers, staff and partners in shaping the design, delivery and improvement of health and social care services to ensure inclusive, rights-based and meaningful engagement informed by lived experience. Engagement is a statutory duty under the Public Bodies (Joint Working) (Scotland) Act 2014 and reinforced by Planning with People Guidance (2024). A clear strategy provides a shared framework for meaningful engagement, strengthens accountability, and helps us build a culture where every voice contributes to shaping health and care services across North Ayrshire. This Plan refreshes North Ayrshire’s previous Participation and Engagement Strategy 2022-2025. 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 Strategy consisted of analysis of engagement activity undertaken between 2022-2025 across Mental Health, Health & Community Care and Children, Families and Justice services, as well as Locality Planning, What Matters to You? and Equalities Engagement processes. Engagement was conducted with groups of shared characteristics, some of whom 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 and members of religious groups. Full details of findings are available in the strategy. 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 3.3, please identify any potential positive and negative impacts on any of these protected characteristics. 112
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Version: 7.0 Protected Characteristic Impact on the Protected Characteristic? (yes, no, not applicable) Please Explain (Positive or Negative or Neutral) Age - Older people, children and young people – please identify which categories will be affected Yes Positive impact: Prioritising engagement with older people, including gathering feedback which could inform future care needs. Strengthening engagement with children and young people. Disability - Physical and Learning Yes Positive impact: Accessible communication commitments and carrying out engagement to understand current service challenges, and opportunities for improvement. There is also a commitment to strengthen engagement with people with physical and invisible disabilities. Gender reassignment - When a person is living in a gender other than their birth gender. Yes Positive impact: There is a commitment to strengthen engagement with people with cultural barriers such as trans and nonbinary individuals. Pregnancy and Maternity Yes Positive impact: commitment to working with families to identify behaviours that support infant health and how to support improved outcomes, such as breastfeeding rates, child healthy weight and immunisations. 113
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Version: 7.0 Protected Characteristic Impact on the Protected Characteristic? (yes, no, not applicable) Please Explain (Positive or Negative or Neutral) Race, ethnicity, colour, nationality or national origins (including gypsy/ travellers, refugees and asylum seekers) Yes Positive impact: Barriers for ethnic minorities identified; mitigated via commitment to inclusive formats and translation support. There is also a commitment to strengthen engagement with people with cultural barriers such as non-native English speakers and ethnic minority groups. Religion or belief (includes religious and philosophical beliefs, including no belief) Not applicable No specific impacts identified. Sex - Women and Men Not applicable No specific impacts identified. Sexual Orientation – such as lesbian, gay and bisexual people. Not applicable While the strategy itself has no aims specific to sexual orientation, it does include supporting the delivery of the IJB Equality outcomes 2025-2029, which has some aims to improve access for the LGBT community. Marriage and Civil Partnership - this includes same sex couples Not applicable No specific impacts identified. Human Rights Yes Positive impact: The Strategy encourages a Rights‑based engagement model to support participation. 114
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Version: 7.0 Protected Characteristic Impact on the Protected Characteristic? (yes, no, not applicable) 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. Yes Positive impact: Dedicated engagement through Champions Boards and Promise activity. Other - Homelessness, ex-offenders, carers, part-time workers Yes Positive impact: There is a commitment to strengthen engagement with people who are homeless and those without fixed addresses. 3.4 Describe any consultation or engagement undertaken, including details of the groups involved and the methods used. Existing Engagement Insights: All engagement evidence between 2022 and 2025 across all HSCP services were gathered and analysed to note methods, strengths, gaps and impact. This supported the identification of new priorities and principles, and actions that would build on previous lessons learned. Engagement Survey: In 2024, the Partnership focused it's What Matters to You? campaign on public engagement, asking individuals how they prefer to be involved and what matters most when sharing their views with us. Key findings highlighted a strong preference for digital engagement (e.g. online surveys, email updates), regular consultation, and clearer communication about how feedback is used. These insights directly informed the development of this Participation and Engagement Strategy. Service input: Services across the HSCP were contacted in August 2025 and asked to complete an engagement activity template for 2025 in order to gather organisation-wide insights about who had been engaged with, how it was 115
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Version: 7.0 carried out, and what the outcomes or outputs were, as well as anything currently being planned. Analysis: Using the gathered evidence, new Principles of engagement were identified as well as Partnership wide priorities which support the implementation of the Strategic Outcomes identified within the refreshed Strategic Plan for 2026-2030. Questions 3.5 to 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 116
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Version: 7.0 3.6 Which aspects of the policy advance equality of opportunity between people who share a relevant protected characteristic and those who do not? The Strategy aims to strengthen inclusive engagement to better reach seldom- heard groups within engagement exercises by improving accessibility, enhancing the opportunity of people that haven't historically been engaged 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. 4. 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). Please delete whichever statement is not applicable from the highlighted text below: Yes, the proposal does have the potential to have a significant impact on inequalities of outcome caused by socio-economic disadvantage. If Yes please provide more information under any of the below headings (4.2 to 4.6) which are relevant, highlighting any evidence and sources of evidence used to inform your information. The Participation and Engagement Strategy identifies that people experiencing socio-economic disadvantage—such as those living in poverty, facing digital exclusion, living in deprived areas, or experiencing homelessness—are 117
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Version: 7.0 currently underrepresented in engagement activity and require targeted support to ensure equitable involvement. The strategy includes specific actions to strengthen engagement with these groups and to reduce inequalities of outcome by embedding inclusive, accessible, and targeted engagement approaches. 4.2 Low Income/Income Poverty: Cannot afford to maintain regular payments such as bills, food and clothing The strategy identifies people with lived experience of poverty and financial exclusion as priority groups requiring strengthened engagement. It commits to: • Direct engagement with financial inclusion service users to understand barriers and improve support pathways. • Reducing participation barriers by offering paper‑based surveys, local collection points, and accessible formats for those who cannot afford digital access. • Embedding engagement within Strategic Priority 3 (Tackling the Root Causes of Inequality), which explicitly focuses on the links between poverty and health outcomes. These actions will have a positive impact by making engagement more accessible to individuals affected by income poverty. 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. The strategy supports this group by: • Providing flexible, free participation options such as drop‑ins, Conversation Cafés, and localised engagement sessions that do not require travel or expense. • Prioritising inclusion through multiple communication formats (digital, paper, in‑person) to remove financial barriers that limit sustained engagement. These measures enable individuals with low or no wealth to be more involved in shaping services. 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 Material deprivation—such as lack of access to transport, digital devices, or basic goods—can directly limit opportunities to participate in engagement. The strategy recognises these barriers and responds through: • Addressing digital exclusion by ensuring all engagement is available offline, in paper formats, and in community settings such as local libraries and GP practices. 118
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Version: 7.0 • Using mobile outreach, pop-up stalls and locality-based engagement, reducing the need for people to travel or pay for transport. • Strengthening engagement with people who are homeless or without fixed addresses, identified as a gap and priority for targeted outreach. These actions directly counter the effects of material deprivation by ensuring engagement is reachable and accessible 4.5 Area Deprivation: Where you live (rural areas), where you work (accessibility of transport. North Ayrshire has areas with significant levels of deprivation, including rural communities and island populations with limited access to transport and services. The strategy addresses area‑based disadvantage through: • The Locality Planning Model, ensuring each locality, including our islands, have tailored, place‑based engagement opportunities that reflect local needs. • Using local venues, local partners, and community events to ensure engagement reaches communities facing geographic disadvantage. • Ensuring digital engagement, as well as in person events, to provide additional opportunities for involvement This approach ensures people in deprived or remote areas have equitable opportunities to shape services. 4.6 If impacts have been identified how will these be mitigated or explored in more detail? (please outline below) Where risks of negative or unequal impacts have been identified, the strategy includes clear mitigation measures: • Targeted outreach to socio-economically disadvantaged groups, including those experiencing poverty, homelessness, deprivation, and digital exclusion. • Flexible, multi-format engagement methods, ensuring no group is excluded due to cost, lack of digital access, language needs, or location. • Strengthened inclusive communication, including Easy Read, translated materials, BSL, and alternative formats. • Pop-up and mobile engagement, reducing travel and cost barriers. • Embedding lived experience voices into service redesign, ensuring disadvantaged groups influence decisions that impact their outcomes. • Continuous monitoring of participation demographics to track representation and address gaps through ongoing improvement. 119
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Version: 7.0 5. 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). Please delete whichever statement is not applicable from the highlighted text below: Yes, there are Children’s Rights impacted by this proposal. 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? Please delete whichever statement is not applicable from the highlighted text below: Yes, some children and young people are more likely to be affected than others. If, Yes what groups? (Consider protected characteristics – for example 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 disabilities or NDD, children and young people transitioning from children’s to adult social work, children and young people with experience of substance use, children and young people affected by poverty or deprivation. 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. 120
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Version: 7.0 Wellbeing indicator (for example, safe, healthy etc.) Children’s Right (for example, 22 – refugee children) Respected Responsible Included Article 2 – Non Discrimination Article 3 – Best interests of the child Article 4 – Implementation of the Convention Article 12 – Respect for the views of the child Article 13 - Freedom of expression 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 5.6 Describe any consultation or engagement that has taken place with young people? The engagement analysis includes engagement carried out with young people including transitions engagement, NDD engagement, and children and young people’s engagement about health and social care priorities. 5.7 If negative impacts are identified how will these be mitigated either fully or in part? N/A 121
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Version: 7.0 6. 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? Please delete whichever statement is not applicable from the highlighted text below: No, the intended outcomes of the proposal do not potentially differ or have a different impact for our Island Communities. 6.2 Please describe the potential impacts for our Island Communities. The impacts of this Strategy will affect Island communities in the same manner as other localities, however due to their unique circumstances, engagement methods and efforts may need to be increased in order to appropriately engage with our island communities. For example, the strategy outlines our priority to enhance locality-based engagement, which will require considering the particular circumstances of each locality. 6.3 Please explain if the impacts are different for communities on different islands? Impacts will not differ for different islands, however the HSCP approach to reach island residents may require to be altered to ensure appropriate reach. 6.4 What consultation or engagement has taken place with our Island Communities? Locality based engagement that was considered as part of the analysis for the plan, which included a locality survey, engagement with Children and young people and engagement with equalities groups. 6.5 How will you address any potential barriers or wider impacts for our Island Communities as identified through this assessment? The Participation and Engagement Strategy will not impact island communities differently from other communities, however the strategy outlines that the approach may need to be altered when carrying out engagement depending on the audience, which includes island communities. 122
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Version: 7.0 7. 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? Please delete whichever statement is not applicable from the highlighted text below: No, the proposal will not impact on consumers. If no, please request then complete the ‘Assessment not required’ by emailing equalities@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 Describe 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 Describe any consultation and engagement that has taken place with consumers around your proposal. Click or tap here to enter text. 7.5 What alternative proposals 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. 123
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Version: 7.0 8. 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 on a protected characteristic group through multiple proposals or existing decisions)? No 8.2 If Crosscutting issues have been 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. 9. Section 9 – Outcome of the Assessment 9.1 Please detail the outcome of the assessment: Please delete whichever outcomes are not applicable from the highlighted text below: a) 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. 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. 124
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Version: 7.0 10. Section 10 – Monitoring 10.1 Describe how you will monitor the impact of this policy for example, performance indicators, actions, 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 and where this will be recorded. The impact of this strategy will be monitored through the Partnership‑Wide Engagement Reporting process, submitted annually to the Strategic Planning Group (SPG). The SPG will review progress, track actions, and ensure a consistent approach across services, with strategic oversight from the Integration Joint Board (IJB). Monitoring will focus on participation levels, inclusion of seldom‑heard groups, evidence of how engagement has influenced decisions, and feedback loop effectiveness. Findings will be recorded through the standard reporting template and stored centrally for transparency and future review. 11. Section 11 – Sign Off 11.1 Head of Service approval of the impact assessment. Name: Stuart MacMillan Title: Principal Manager – Planning, Performance and Transformation Date: 2 February 2026 12. Section 12 – Publication 12.1 Following approval by Head of Service, completed Impact Assessments are published on our Council’s External Website. Please email: equalities@north-ayrshire.gov.uk 125
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Integration Joint Board 12th February 2026 Subject: 2025-26 – Month 9 Financial Performance Purpose: To provide an overview of the IJB’s financial performance as at Month 9 (December). 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 £4.479m reducing to £3.276m 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 (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 refers to the position at the end of December further work is undertaken following the Agenda Item 8 127
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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 £4.479m (1.3%) reduced to £3.276m 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 @ mth9 4.479 1.111 3.368 Financial Recovery Plan Projections 1.203 0.771 0.432 Residual Risk 3.276 0.340 2.936 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 month 9 position reports a significant projected overspend on the North Ayrshire Council Services and this is unlikely to be fully mitigated by the proposed recovery action. Following approval by the IJB, the Chief Officer will write formally to North Ayrshire Council to request additional in-year funding to support the remaining overspend, subject to pursuing further recovery actions, with the residual position being: • North Ayrshire Council £2.936m At this stage the NHS projected overspend is partially mitigated by recovery action but this dependent on the full request for the shortfall in the reduced working week (RWW) of £0.551m being provided in full. The Health Board Director of Finance has offered partial funding which is insufficient and this has been returned for further consideration. 1.3 The movement in the projected outturn position for the 2025-26 financial year is illustrated in the graph below, this illustrates the movement in the gross and net projected overspend and the residual overspend or risk split between NHS and LA funding partners. 128
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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 7 to Period 9 are: Favourable: • Care at Home £0.578m • Care Homes £0.221m • Integrated Islands £0.074m • Ward 1 and 2 £0.067m • Action 15 £0.054m • Lead Partnership payroll turnover £0.244m • Transition slippage £0.051m Adverse: • Adult Mental Health Inpatients £0.478m • LD Services within the Lead Partnership £0.130m • Children’s Residential placements £0.172m • Learning and Development income £0.083m • Social Care payroll turnover £0.400m • Recharge from East lead partnership £0.377m The position pre-recovery plan has improved by £0.467m, and this reflects the achievement of recovery plan action e.g. care at home and care homes. This means 5.187 5.259 4.957 4.946 4.946 4.479 1.175 1.733 1.604 1.939 1.939 3.276 0.519 0.776 0.001 0.058 0.058 0.34 0.656 0.957 1.603 1.881 1.881 2.936 -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 Period 8 Period 9 Projected Outturn Movement Gross PO Net Total PO Net NHS PO Net LA PO £m 129
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there is less scope for recovery action resulting in the position after recovery action deteriorating. 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 the new Lead Partnership reporting template is included as Appendix G. 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 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 9 At month 9 against the full-year budget of £339.036m there is a projected year-end overspend of £4.479m (1.3%). The Integration Scheme outlines that there is an expectation that the IJB takes account of the totality of resources available to balance 130
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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 £3.368m in social care services and a projected overspend of £1.111m 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 £99.717m there is a projected overspend of £2.957m (3%) which is a favourable movement of £1.159m and the main variances are: a) Care home placements – net projected overspend of £0.324m (£0.221m favourable). This includes an overspend on placements of £0.774m (£0.321m 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 9 there were 795 placements resulting in a projected overspend of £0.774m. 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, this has led to a growing waiting list for access. The overspend is partially offset by income recovered from charging orders and gross funded placements which is projected to be £0.450m over recovered (£0.100m adverse). This income is challenging to predict as it depends on the length of the legal process and time taken to sell the property that the charging order is registered to and access to the funds or estate of service users. b) Care at home is projected to be £1.143m overspent (£0.578m favourable). The position reflects the cost of meeting the significant demand and level of provision for care at home support. The favourable movement is due to the action being taken to reduce the overall level of provision. The level of vacancies in the service has increased and whilst favourable it is coupled with increased levels of unmet need. c) Physical Disability Services – projected overspend of £0.326m (£0.028m adverse) split as follows: £1.004m over in residential placements, £0.407m under in direct payments due to increased clawbacks and £0.271m under in community care packages. 131
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d) Integrated Island Services is projected to overspend by £0.413m (£0.074m favourable). The most significant variance is a projected overspend at Montrose House of £0.353m 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 £0.195m (£0.037m adverse) (Redburn ward £0.191m overspend and Douglas Grant £0.004m overspend). 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 £0.703m (£0.067m 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. The projection for Health and Community Care services assumes that the allocation of unscheduled care funding will be fully utilised. 2.4 Mental Health Services Against the full-year budget of £118.470m there is a projected overspend of £1.720m (1.45%) which is an adverse movement of £0.217m 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 £1.199m (£0.050m favourable). • Community Mental Health services are projected to underspend by £0.111m (£0.021m 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. 132
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• The Lead Partnership for Mental Health is projected to be £0.976m overspent (£0.288m adverse) and the main variances are as follows: • Adult Inpatients – projected overspend by £1.429m (£0.478m adverse) due to very high levels of occupancy, patient mix and complexity and levels of continuous intervention which require additional supplementary staff and enhanced observations (1:1 and 2:1) and use of bank staff. The adverse movement relates to removal of previously assumed income (£0.600m) that would be recharged to another authority. • The UNPACS (Unplanned Activities) budget – projected overspend of £1.182m (£0.035m adverse) based on current placements. UnPACS placements are for individuals with very specific needs that require a higher level of security and/or care from a staff group with a particular skill set/competence. There are no local NHS secure facilities for women, people with a learning disability or people with neurodevelopmental disorder. This can necessitate an UNPACs placement with a specialist provider which can be out-of-area. The nature of mental health UNPACs spend is that it is almost exclusively 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 requests, the projected position includes provision for any new placements approved. • Learning Disability Services – projected to overspend by £0.435m (£0.130m adverse). 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 and some patients remain within Woodland View. • Elderly Inpatients – projected overspend of £0.129m (£0.008m adverse) due to the use of supplementary staffing. The elderly mental health wards continue to operate at full occupancy with waiting lists, with several patients who are on enhanced observations and bank costs remain high. 133
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• 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. • Psychiatry – is projected to overspend by £0.315m (£0.044m adverse) mainly due to junior doctor costs. A mitigation plan is being developed and the rota for junior doctors is being reviewed. A wholescale workforce review has been commissioned to determine longer term solutions for sustainability. • MH Pharmacy – is projected to overspend by £0.064m (£0.048m 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 £0.375m (£0.054m 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. • 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 £1.347m (favourable movement of £0.244m) in 2025-26. Further information is included in the table below: Vacancy Savings Target (£1.160m) Projected to March 2026 £2.507m Over/(Under) Achievement £1.347m 134
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2.5 Children and Justice Services Against the full-year budget of £42.254m there is a projected overspend of £1.627m (3.9%) which is an adverse movement of £0.017m and the main variances are: a) Care Experienced Children and Young People is projected to overspend by £2.146m (£0.130m 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 £2.970m (£0.172m adverse) based 35 placements in month 9. 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 4 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. 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. Note that the costs associated with mobilising Boyle Street are being finalised and will be included in the month 10 report. • Looked After and Accommodated Children (fostering, adoption, kinship etc) is projected to be £0.851m (£0.047m adverse) underspent. 135
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• Residential respite – placements are overspent by £0.056m (£0.014m 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 £0.114m (£0.035m favourable), largely due to staffing levels in the children’s houses and regrading of posts. • Care Leavers – projected underspend of £0.046m (£0.003m favourable) in rent costs. • Section 29 Payments (Throughcare Team) are projected to overspend by £0.046m (£0.001m adverse movement). b) Head of Service – is projected to underspend by £0.658m (£0.036m 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 £0.776m £0.011m favourable) and which contributes to costs incurred across a number of C&F service areas. The favourable movement relates to additional funding and movement with costs associated with CP Independent Chair. c) C&F Health Team – is projected to overspend by £0.137m (£0.007m favourable) 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. 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 £0.073m (£0.083m adverse). The adverse movement mainly relates to a reduction in income in Learning and Development as some as the expected income will not be achieved until 2026/27. 2.8 MANAGEMENT AND SUPPORT Management and Support Services are projected to underspend by £1.831m (£0.233m adverse), and the main areas of variance are: 136
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• There is projected slippage on the LD and MH transition funding of £0.533m (£0.051m 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 (no movement) 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 £0.150m (£0.400m adverse) for social are services and an over-recovery of £0.282m (£0.038m favourable) 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 £3.550m £1.849m Over/(Under) Achievement £0.150m £0.282m 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. 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. 137
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2.9 Savings Progress The approved 2025-26 budget included £4.019m of savings. BRAG Status Position at Budget Approval £m Position at Month 9 £m Red - 1.000 Amber 2.984 1.027 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 red and amber rated savings are already reflected in the projected outturn. From month 7 to 9 the rating of the Brighter Pathways has increased from Amber to Red as the majority of the moves required to achieve this saving will not be implemented until month 12 onwards so a full year saving will not be made. 2.10 Budget Changes The Integration Scheme states that “either party may increase it’s in year payment to the Integration Joint Board. Neither party may reduce the payment in-year to the Integration Joint Board nor Services managed on a Lead Partnership basis…. without the express consent of the Integration Joint Board.” Appendix C highlights the movement in the budget position following the initial approved budget. Reductions Requiring Approval: Ref Description Amount (£000) 1 ICT transfer 4 2 GP Prescribing adjustment 365 3 BBV funding returned to public health 8 4 Training Grade adjustment 71 2.11 Pan Ayrshire Lead Partnership services and Large Hospital Set Aside Lead Partnerships: - 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 the new Lead Partnership reporting template is included as Appendix G. 138
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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 £493.5million. The directorate is overspent by £27.2 million after 9 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 £5.2m after 9 months. Within the overall £27.2 million overspend Medicine are over by £10.9 million, Emergency Care by £8.9 million, Surgery by £3.5 million, Labs and Diagnostics by £2.8 million and Women and Children by £2.0 million. 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. 139
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The IJBs and the Health Board work closely in partnership to maintain service and improve performance. 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. • 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. 140
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• 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, 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 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 - - - - 141
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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 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. 142
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MANAGEMENT ACTIONS/CONTROLS AGREED IN 2025/26 (AUGUST, SEPTEMBER AND DECEMBER 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. • 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. • Care at home – recruitment freeze to gradually reduce the overspend position. Again, this will impact on wait times and service performance. • 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. RECOVERY ACTIONS – MONTH 9 UPDATE • The updated recovery action is outlined in Appendix E. This includes the proposals agreed since month 3 and updated progress at month 9 and any changes to target reductions. The actions are a mix of cost reduction targets across various services and a drawdown of reserves. • There is a significant risk at this point in the financial year that 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 Month 7 1.939 0.058 1.881 143
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• At month 9 this deteriorated to: TOTAL Health/ NHS AA Social Care/NAC Projected Overspend @ mth9 4.479 1.111 3.368 Financial Recovery Plan Projections 1.203 0.771 0.432 Residual Risk 3.276 0.340 2.936 • This plan is monitored and reviewed each month, and the following recovery actions are being proposed at month 9: o Seek to improve sickness absence rates through utilisation of Promoting Attendance Policy o Pursue cross-charge for persons admitted from out-of-area following failed placements in Ayrshire and Arran o Continue to progress implementation of Flexible Intervention Guideline to minimise length of time someone requires 1:1 (or higher) support. 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 £4.479m (1.3%) 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 144
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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 is on our strategic risk register. 4.6 Community Wealth Building None. 4.7 Key Priorities The ability to deliver on our strategic priorities may be compromised due to the greater financial risk faced in 2025-26 and 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] 145
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PUBLIC INFORMATION 2025-26 Budget Monitoring Report–Objective Summary as at 31st December 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 78,684 80,644 1,960 21,033 22,030 997 99,717 102,674 2,957 4,116 (1,159) : Locality Services 32,817 33,564 747 5,854 5,854 0 38,671 39,418 747 899 (152) : Community Care Service Delivery 41,652 42,455 803 0 41,652 42,455 803 1,677 (874) : Rehabilitation and Reablement 2,105 2,156 51 0 2,105 2,156 51 51 0 : Long Term Conditions 896 942 46 10,646 11,544 898 11,542 12,486 944 1,003 (59) : Community Link Workers 342 341 (1) 0 0 0 342 341 (1) (1) 0 : Integrated Island Services 872 1,186 314 4,533 4,632 99 5,405 5,818 413 487 (74) MENTAL HEALTH SERVICES 41,131 42,228 1,097 77,339 77,962 623 118,470 120,190 1,720 1,503 217 : Learning Disabilities 32,053 33,252 1,199 733 733 0 32,786 33,985 1,199 1,249 (50) : Community Mental Health 7,063 6,952 (111) 1,792 1,792 0 8,855 8,744 (111) (90) (21) : Addictions 2,015 2,024 9 1,901 1,901 0 3,916 3,925 9 9 0 : HBCCC 0 0 0 353 0 (353) 353 0 (353) (353) 0 : Lead Partnership Mental Health NHS Area Wide 0 0 0 72,560 73,536 976 72,560 73,536 976 688 288 CHILDREN & JUSTICE SERVICES 36,359 37,947 1,588 5,895 5,934 39 42,254 43,881 1,627 1,610 17 : Irvine, Kilwinning and Three Towns 3,247 3,293 46 0 0 0 3,247 3,293 46 71 (25) : Garnock Valley, North Coast and Arran 3,605 3,688 83 0 0 0 3,605 3,688 83 81 2 :Intervention Services 1,814 1,814 0 0 0 0 1,814 1,814 0 12 (12) : Care Experienced Children & Young people 22,755 24,901 2,146 0 0 0 22,755 24,901 2,146 2,016 130 : Head of Service - Children & Families 1,406 748 (658) 0 0 0 1,406 748 (658) (622) (36) : Justice Services 3,101 3,101 0 0 0 0 3,101 3,101 0 0 0 : C&F Health Team 431 402 (29) 5,015 5,126 111 5,446 5,528 82 88 (6) : Lead Partnership NHS Children's Services 0 0 0 880 808 (72) 880 808 (72) (36) (36) CHIEF SOCIAL WORK OFFICER 1,975 1,902 (73) 0 0 0 1,975 1,902 (73) (156) 83 PRIMARY CARE 0 0 0 53,262 53,259 (3) 53,262 53,259 (3) (17) 14 ALLIED HEALTH PROFESSIONALS 0 11,528 11,528 0 11,528 11,528 0 0 0 MANAGEMENT AND SUPPORT COSTS 8,033 6,829 (1,204) 3,797 3,403 (394) 11,830 10,232 (1,598) (1,831) 233 OUTTURN ON A MANAGED BASIS 166,182 169,550 3,368 172,854 174,116 1,262 339,036 343,666 4,630 5,225 (595) Return Hosted Over/Underspends to East 0 0 0 0 (320) (320) 0 (320) (320) (225) (95) Return Hosted Over/Underspends to South 0 0 0 0 (279) (279) 0 (279) (279) (196) (83) Receive Hosted Over/Underspends South 0 0 0 0 33 33 0 33 33 104 (71) Receive Hosted Over/Underspends East 0 0 0 0 415 415 0 415 415 38 377 OUTTURN ON AN IJB BASIS 166,182 169,550 3,368 172,854 173,965 1,111 339,036 343,515 4,479 4,946 (467) Over/ (Under) Spend Variance at Period 7 Movement in variance from Period 7 TOTAL Partnership Budget - Objective Summary Council Health 2025/26 Budget 146
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2025-26 Savings Tracker Appendix B Social Care: Ref Description Deliverability Status at budget setting Deliverability Month 9 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 Red 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 147
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Health: Ref Description Deliverability Status at budget Deliverability Month 9 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 4.019 148
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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 0.009 ICT Transfers 9 P (0.004) Roundings 9 0.001 166.182Social Care Budget Reported at Month 9 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 0.174 149
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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) Drug Death Co-ordinator funding returned to PH (retiral - post funding returned) (0.040) BBV funding returned to PH (reduction in hours) 8 (0.008) Training Grade Adjustment (Dean Funding) - December 8 (0.071) Training Grade Rates Adjustment - December 9 0.086 Early Years funding 0.49 WTE Band 4 - MIN Allocation 9 0.020 GP Prescribing budget adjustment 9 (0.365) ANTICIPATED BUDGETS INCL HERE (NOT IN LEDGER) 9 (1.288) Roundings (0.003) 172.854 TOTAL COMBINED BUDGET 339.036 Health Budget Reported at Month 9 150
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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 3,161 151
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Financial Recovery Action Plan Appendix E £m Projected Overspend at Month 9 4,479 SERVICE AREA Current Target at Month 9 Proposed Target at Month 9 Achieved at Month 9 Still to be achieved Target set (IJB Date) Community Care and Health a) Care home placements (329) (500) (400) (100) August 2025 - month 3 report b) Physical Disability Services (res, community and DPs) 0 0 0 0 August 2025 - month 3 report c) Specialist Rehab wards (100) (100) (57) (43) August 2025 - month 3 report d) Wards 1 and 2 (217) (175) (124) (51) August 2025 - month 3 report e) Care at Home (300) (750) (578) (172) August 2025 - month 3 report TOTAL (946) (1,525) (1,159) (366) Mental Health Services Current Target at Month 9 Proposed Target at Month 9 Achieved at Month 9 Still to be achieved Target set (IJB Date) a) Learning Disabilities 0 0 0 0 August 2025 - month 3 report b) Community Mental Health services 0 0 0 0 August 2025 - month 3 report c) Lead Partnership for Mental Health : 0 0 - Adult Inpatients (100) (75) 0 (75) August 2025 - month 3 report - Elderly Inpatients (150) (150) (62) (88) August 2025 - month 3 report - Psychiatry (150) (50) (14) (36) August 2025 - month 3 report - Action 15 Reserves (486) (486) (486) 0 August 2025 - month 3 report - Enhanced MH Outcome Framework Reserves (624) (624) (624) 0 August 2025 - month 3 report NORTH AYRSHIRE ELEMENT 38.65% (584) (584) (458) (126) August 2025 - month 3 report TOTAL (584) (584) (458) (126) 152
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SERVICE AREA Current Target at Month 9 Proposed Target at Month 9 Achieved at Month 9 Still to be achieved Target set (IJB Date) Children and Justice Services Target set (IJB Date) a) Residential Placements (400) (20) 0 (20) August 2025 - month 3 report TOTAL (400) (20) 0 (20) ALLIED HEALTH PROFESSIONALS 0 0 0 0 August 2025 - month 3 report CHIEF SOCIAL WORK OFFICER 0 0 0 0 August 2025 - month 3 report MANAGEMENT AND SUPPORT a) Payroll turnover 0 0 0 0 August 2025 - month 3 report b) Transition slippage (125) (150) (125) (25) August 2025 - month 3 report c) Contractual inflation (115) (115) (100) (15) August 2025 - month 3 report d) Service Redesign Fund (100) (100) (100) November 2025 - moth 6 report TOTAL (340) (365) (225) (140) OTHER AREAS b) Agenda for Change - assume fully funded (551) (551) 0 (551) August 2025 - month 3 report (551) (551) 0 (551) TOTAL RECOVERY ACTION (2,821) (3,045) (1,842) (1,203) Remaining projected overspend 3,276 153
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Bank and Agency Costs to Month 9 Appendix F 1) NHS 4863 (Registered) 4864 (Unregistered) 4853 (Registered) 4854 (Unregistered) TOTAL NORTH CORE SLT ADULT 3,098 3,098 WARD 1 WOODLANDS VIEW 41,006 222,323 263,329 WARD 2 WOODLANDS VIEW 23,337 319,637 342,974 ACH REDBURN REHAB WARD NRS 23,857 147,834 171,691 ACH DOUGLAS GRANT REHAB WD NRS 29,210 68,191 97,400 WARD 3 WOODLANDS VIEW NURSING 10,647 303,068 313,715 WARD 4 WOODLANDS VIEW NURSING 1,605 35,993 37,598 NEW CLONBEITH NURSING(JURA) 83,798 124,173 207,971 WVIEW THE GLEN ECT 4,939 10,222 15,162 WVIEW WARD 10 ACUTE MH NRS 5,576 215,351 220,927 WVIEW WARD 8 ACUTE MH NRS 19,000 665,038 684,038 WARD 5 WOODLANDS VIEW 2,562 39,962 42,524 WVIEW WARD 7B REHAB MH NRS 7,419 7,419 NEW DUNURE NURSING(CLONBEITH) 29,685 161,801 191,486 MH BED MANAGEMENT 20,920 20,920 TRINDLEMOSS 51,949 242,047 293,996 ARRAN HOSPITAL NURSING 61,859 38,415 100,274 CAMHS MANAGEMENT 1,944 1,944 CAMHS UNSCHEDULED CARE 1,482 1,482 EARLY YRS-C/F TEAM 1 923 923 EARLY YRS-C/F TEAM 3 974 974 IMMUNISATION NURSING 55,249 17,611 72,859 ARRAN DN 13,862 13,862 PACKAGE OF CARE (P) - AMG 103,722 103,722 PACKAGE OF CARE (P) - LMO 879 879 NC POC TEAM 2 990 990 NC POC TEAM 3 3,843 3,843 THREE TOWNS DN 1,187 1,187 FOXGROVE(NSAIS)ADVANCE RECRUIT 25,661 25,661 NORTH AHP MANAGEMENT TEAM 7,329 7,329 IRVINE DN 16,516 16,516 NORTH WEST COAST DN 29,774 29,774 GARNOCK VALLEY DN 52,203 52,203 LADY MARGARET NURSING 8,467 4,194 12,661 PREVENTION + SERVICES SPT TEAM 2,397 2,397 LD HEALTH CHECKS 12,238 12,238 NORTH CLDT 5,777 164 5,941 LDS MANAGEMENT 4,642 4,642 MHANPS MH UNSCHEDULED CARE 2,355 57 2,412 MHS INPATIENT MGT 15,113 210 15,323 CMHT NURSING-NORTH AYRSHIRE 9,362 5,890 15,252 WVIEW WARD 7C FORENSIC REHAB N 7,692 128,882 371 136,944 INTENSIVE COMMUNITY NURSING TEAM 36,520 2,417 38,937 ADULT MENTAL HEALTH LIASION TEAM 34,864 34,864 PCMHT NORTH 1,798 1,798 WVIEW WARD 6 LOW SECURE NRS 47,174 147,066 194,241 WARRIX AVE 97,883 73,923 171,805 ICFN - COMMUNITY PHLEBOTOMY 11,906 11,906 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 21,180 314,561 226 335,968 WVIEW WARD 11 ACUTE MH NRS 35,559 196,382 231,941 963,357 4,070,599 2,400 14,532 5,050,888 2) SOCIAL CARE Mth 9 Spend 260,647 103,863 18,706 500,592 97,334 981,142 Mh Acm Bank Agency Montrose House Brodick Unscheduled Care Funding Ld Acm Children Acm 154
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Official APPENDIX G Lead Partnership Report Background: The Integration Scheme creates various Lead Partnership roles across the three Ayrshire Integration Joint Boards. Each IJB, acting as lead partner, commissions services on behalf of the three Ayrshire IJBs and reclaims the costs involved. This arrangement is treated as an agency arrangement. The projected outturn position for each IJB is adjusted to reflect the impact of Lead Partnership services. The over or underspend in relation to each Lead Partnership services is not fully attributed to that partnership, and a share will be allocated to the other Ayrshire IJBs on an NRAC* basis in line with the agreed risk sharing mechanism. Within the Integration Scheme, as with all delegated budgets, the intention is that services managed under Lead Partnership arrangements should be delivered within budget. Should that not be possible, a financial recovery plan requires to be developed and approved by all three Integration Joint Boards. Should financial recovery plans for Lead Partnership services fail, then all IJBs are required to address any shortfalls which are not related to base line budget issues. 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. *NRAC and the percentage information is explained later in the report 155
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Official 1. SUMMARY 1.1 The summary of the financial position month 9 is given in the table below: Further detail by IJB is given below. Allocation of Variance IJB Area of Service Period Covere d Budget £’000’s Outturn £’000’s Variance £’000’s North £’000’s South £’000’s East £’000’s North Mental Health Lead Partnership Month 9 72,560 73,536 (976) (377) (279) (320) North Children Lead Partnership Month 9 880 808 72 27 21 24 South Community Store Month 9 1,203 1,203 0 0 0 0 South Family Nurse Partnership Month 9 2,804 2,833 (29) (11) (9) (9) South Continence Team Month 9 572 632 (60) (22) (19) (19) East Standby Services Month 9 319 319 0 0 0 0 East Primary Care (including Dental) Month 9 139,678 141,259 (1,581) (585) (492) (504) East Prison and Police Healthcare Month 9 4,233 4,086 147 54 46 47 East Allied Health Professionals (Lead) Month 9 5,537 5,159 378 140 118 121 East Other Lead Services Month 9 2,321 2,387 (66) (24) (21) (21) 2. North Ayrshire: 2.1 Services managed under Lead Partnership arrangements by North Ayrshire Integration Joint Board are projected to overspend by £0.904m in total. This equates to 1.2% of delegated Lead Partnership budget. 2.2 Allocation of Variance IJB Area of Service Budget £000’s Outturn £000’s Variance £000’s North £000’s South £000’s East £000’s North Mental Health Lead Partnership 72,560 73,536 (976) (377) (279) (320) North Children Lead Partnership 880 808 72 27 21 24 2.3 • The Lead Partnership for Mental Health is projected to be £0.976m overspent (£0.288m adverse) and the main variances are as follows: 156
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Official • Adult Inpatients – projected overspend by £1.429m (£0.478m 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 adverse movement relates to removal of income previously assumed would be recharged to another authority. • The UNPACS (Unplanned Activities) budget – projected overspend of £1.182m (£0.035m adverse) based on current placements. UnPACS placements are for individuals with very specific needs that require a higher level of security and/or care from a staff group with a particular skill set/competence. There are no local NHS secure facilities for women, people with a learning disability or people with neurodevelopmental disorder. This can necessitate an UNPACs placement with a specialist provider which can be out-of-area. The nature of mental health UNPACs spend is that it is almost exclusively 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 requests, the projected position includes provision for any new placements approved. • Learning Disability Services – projected to overspend by £0.435m (£0.130m adverse). 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 £0.129m (£0.008m 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. 157
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Official • Psychiatry – is projected to overspend by £0.315m (£0.044m adverse) mainly due to junior doctor costs. A mitigation plan is being developed and the rota for junior doctors is being reviewed. • Mental Health Pharmacy – is projected to overspend by £0.064m (£0.048m 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 £0.375m (£0.054m 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. 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 £1.347m (favourable movement of £0.244m) in 2025-26. Further information is included in the table below: Vacancy Savings Target (£1.160m) Projected to March 2026 £2.507m Over/(Under) Achievement £1.347m 2.4 Recovery Plan Action • The Chief Officer 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. • High-cost care package group – the remit of this group will be expanded to include all UNPACs placement requests. • Seek to improve sickness absence rates through utilisation of Promoting Attendance Policy • Pursue cross-charge for persons admitted from out-of-area following failed placements in Ayrshire and Arran 158
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Official • Continue to progress implementation of Flexible Intervention Guideline to minimise length of time someone requires 1:1 (or higher) support. 2.5 Performance Information • The elderly and adult 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. 3. South Ayrshire: 3.1 Services managed under Lead Partnership arrangements by East Ayrshire Integration Joint Board are projected to overspend by £0.089m in total. This equates to 1.9% of delegated Lead Partnership budget. 3.2 Allocation of Variance IJB Area of Service Budget £000’s Outturn £000’s Variance £000’s North £000’s South £000’s East £000’s South Community Store 1,203 1,203 0 0 0 0 South Family Nurse Partnership 2,804 2,833 (29) (11) (9) (9) South Continence Team 572 632 (60) (22) (19) (19) The main variances are as follows: • Community Equipment Store projected to come in line with budget, favourable movement of £131k from period 6. Whole System Intervention funding allocation has been provided to mitigate pressures to ensure timely discharge from hospital. This funding has meant the planned recovery action to reduce spend on non-fixed costs in line with budgeted monthly budget has been relaxed, additional funding will be used to maintain demand to ensure no impact to whole system flow. Budget Pressure of £0.429m approved by all HSCP's and added to Budget 25/26. • Family Nurse Partnership – projected overspend of £0.029m, favourable movement of £0.058m from period 6, due to vacancies not expected to be filled by the end of year. FNP - projected overspend of £0.065m, Scottish Government funding based at midpoint of salary, all posts in place at top of scale. SG have confirmed no additional funding will be provided. School Student Nurses projected underspend of £0.037m, since period 6 there are now 2 Band 6 nurse vacancies, with one projected to be filled at end of March 26. Team Leader to review and work within budget. 159
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Official • Continence – projected overspend £0.060m, favourable movement £0.004m. Continence Advisors £0.023m projected overspend 0.32FTE @ Band 3 additional to establishment £12k, and 1 B6 £10k who is now redeployed. Supplies £0.037m projected overspend due to increase spend in servicing to nursing homes. Projection includes £50k Ontex rebate (£25k 24/25 and £25k 25/26). Work ongoing with provider and DN teams across A&A to reduce spend to look at practice of continence assessments and use of different products to ensure in line with budget for 26/27. 3.3 Recovery Plan Action Community Equipment Store - £0.080m projected overspend in period 3. The service has been provided with a monthly budget that can be spent on equipment and supplies, this is after taking account of contracted service and maintenance costs that are fixed amounts required to ensure equipment is maintained and serviced in line with relevant legislation. The service was managing within this budget to reduce spend. Scottish Government Whole System Intervention Funding of has since been allocated to ensure supplies are available for timely discharge from hospital, avoiding the need to reduce spend and impact on delayed discharges. This funding is non-recurring and available in 2025/26 only. Family Nurse Partnership- £0.101m projected overspend in period 3, the Scottish Government have now baselined the original funding allocation for FNP of £1.7m, this did not take account of pay wards and increments, leaving a £0.101m shortfall. The AAHB Nurse Director wrote to Scottish Government to request additional funding for FNP to ensure the service is maintained, confirmation has since been received that no funding will be forthcoming. Financial mitigation of £0.058m in year includes not replacing staff and reducing staff hours, caseloads have been adjusted as a result of reduced capacity. SBAR for 26/27 Budget Pressures to be reviewed. 3.4 Performance Information To be further developed 4. East Ayrshire: 4.1 Services managed under Lead Partnership arrangements by East Ayrshire Integration Joint Board are projected to overspend by £1.122m in total. This equates to 0.7% of delegated Lead Partnership budget. 160
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Official 4.2 Allocation of Variance IJB Area of Service Budget £000’s Outturn £000’s Variance £000’s North £000’s South £000’s East £000’s East Standby Services 319 319 0 0 0 0 East Primary Care (including dental) 139,678 141,259 1,581 (585) (492) (504) East Prison and Police Healthcare 4,233 4,086 (147) 54 46 47 East Allied Health Professionals (Lead) 5,537 5,159 (378) 140 118 121 East Other Lead Services 2,321 2,387 66 (24) (21) (21) The main variances are as follows: • Allied Health Professions (Lead Partnership) - £0.378m projected underspend which mainly relates to staffing savings. An increase in overall supplies expenditure has seen a small adverse movement from month 6 projected underspend £0.420m. • Primary Care and Out of Hours Services (Lead Partnership) - £1.581m projected overspend which is an adverse movement of £0.408m at month 6. The projected overspend includes two provisions in relation to backdates Ayrshire Urgent Care Services holiday pay from 1 July 2023 to 30 June 2025 based on 12.8% of total cost paid over that period and five years of backdated Statutory Maternity Pay in GP Practices costing £1.350m and £0.156m respectively. There are projected additional costs within Primary Care Contracting and Support £0.098m (£0.402m overspend month 6) The favourable movement relates to a budget realignment of historic savings following work undertaken to finalise the funding source, partially offset by adverse variances, including new Office 365 licence costs and additional spend related to the GP Sub-Committee and staffing costs. Primary Medical Services are projected to overspend by £0.666m (£0.643m at month 6), largely due to increased pension and sickness cover costs. Primary Medical Services payments also show an overspend due to additional IT costs. These projected additional costs are being partially offset by a projected underspend £0.159m (£0.309m at month 6) against Ayrshire Urgent Care Services based on average of month 1 to 9 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 Care Pathway costs £0.823m (projected to outturn £0.249m over allocated funding). Funding has also been allocated to Covid-19 Therapeutics of £0.274m, with costs projected at £0.231m. There is a projected underspend of £0.505m (£0.555m at month 6) in Dental services that reflects that staffing numbers are running at less than establishment, alongside reduced equipment costs. • Prison and Police Healthcare (Lead Partnership) - £0.147m projected underspend at month 9 (£0.013m overspend month 6) is due to realignment of budget of £0.192m to offset 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 had approved additional funding to offset this pressure however North Ayrshire IJB 161
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Official did not provide for this in their approved budget. The additional funding has now been allocated against the prescribing budget, with North Ayrshire IJB agreeing to allocate additional funding towards Specialist Mental Health Unplanned Activities (UnPACS) (hosted in North Ayrshire) to account for this in the current financial year, with work to be undertaken to align resources as part of the 2026/27 budget-setting process. • Other Services (Lead Partnership) - £0.066m projected overspend (£0.095m overspend month 6). The £0.066m projected overspend (£0.095m overspend month 6) is due to reduced Area Wide Evening Services, with continuing Palliative Care Services cost pressures. 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. • Children’s Services - £0.112m projected underspend (£0.006m overspend at month 6) is largely due to reduced staffing costs. 4.3 Recovery Plan Action The East Ayrshire Lead Partnership projected overspend £1.122m represents an adverse movement from month 6. This is largely due to a provision of £1.350m related to a legal challenge in respect of holiday pay entitlement for GPs undertaking Ayrshire Urgent Care Services sessions. This issue was initially communicated by NHS Ayrshire & Arran at month 6 and has been discussed with the NHS Ayrshire & Arran Interim Chief Executive and Director of Finance. As a consequence of this discussion, it is considered prudent to include this as a provision for backdated costs at month 9. In addition, the projected outturn position includes a provision of £0.156m related to five years back payment of Statutory Maternity Pay costs to GP Practices. Primary Care colleagues are currently working with GP Practices to finalise the sum due, however it is considered prudent to include this provision for backdated costs at month 9. Both provisions were included within the month 8 summary Financial Management Report to the Audit and Performance Committee on 27 January 2026. No additional Financial Recovery Plan proposals for East Ayrshire hosted services are included within this report, with further discussions required with NHS Ayrshire & Arran regarding funding implications, as well as how these pressures are to be managed going forward. 4.4 Performance Information To be further developed 5. NRAC 5.1 NRAC is the NHS Scotland Resource Allocation Committee Formula, a method to allocate funding to NHS Scotland Health Boards. Its primary objective is to promote equitable access to healthcare by assessing each board's relative need based on factors like population size, characteristics influencing healthcare needs, and service delivery 162
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Official costs. The formula sets "target shares" for funding distribution, although final allocations may differ to ensure funding stability. 6. Reporting Cycle North: Month 3,4,6,7,9,10 and 12 South: Month 3,6,9,10 and 12 East: Month 2, 4, 6, 9 and 12 163
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Integration Joint Board 12th February 2026 Subject : Fees and Charges 2026-27 - Social Care Services Purpose : To outline the proposed charges for provided adult social care services for 2026/27 Recommendation : To approve the proposed charges and remit this to a meeting of North Ayrshire Council for formal ratification. Direction Required to Council, Health Board or Both Direction to :- 1. No Direction Required 2. North Ayrshire Council X 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership 1. EXECUTIVE SUMMARY 1.1 Charging and contributing for social care services in North Ayrshire is aligned with the annual update of COSLA National Strategy and Guidance for Charging Applying to Non-Residential Care Services and the Charging for Residential Accommodation Guidance (CRAG). The National Guidance is intended to assist Local Authorities and Integration Authorities to determine whether to charge a person for social care support, and in calculating how much - which is usually done through a financial assessment process. 1.2 This report details proposed charges for social care services for 2026/27, which will be reflected in the Integration Joint Board’s Revenue Budget and seeks IJB approval to submit these proposals to North Ayrshire Council to approve these charges as part of their 2026/27 budget setting. The schedule in Appendix 1 sets out the current charges, proposed 2026/27 charges and indicative charges for the following two years. The revised charges are estimated to increase income by £0.120m in 2026/27. Agenda Item 9 165
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1.3 The proposed charges for 2026/27 are informed by the 2025/26 review of charges, benchmarking with other areas and with consideration of the costs of delivering services. The outcome of this was an individual charge uplift basis rather than a general inflationary increase to charges across social care services, this also included the introduction of new charges for services. The proposals have been shared and discussed at the IJB Finance Working Group. 1.4 The approved charges will be included in the annual review of the Charging Policy which will be published on the NAHSCP website. 2. BACKGROUND 2.1 North Ayrshire Health and Social Care Partnership (NAHSCP) support adults to ensure they are able to live as well and independently as possible. To help the Partnership provide services which meet people’s identified outcomes, we may charge a contribution to the cost of the care. 2.2 The charging policy is reviewed annually and any revisions to charges and financial assessment rules are approved by North Ayrshire Council as part of the annual budget setting process. The legal basis for setting charges remains with the Local Authority, however Integration Authorities can agree charges as part of financial planning and budget setting processes. 2.3 What services do we charge for? • Administration of Blue Badge scheme • Community support (non-personal care only) • Day care • Meals at home • Telecare (includes community alarm, which is a chargeable service) • Respite care (when required for your care needs rather than to give your carer a break from caring duties) • Residential Care – including Montrose House What services do we not charge for? • Care management. • Children’s care and support. • Criminal justice social work. • Information and advice. • Needs assessment. • Respite care (when part of a carer’s assessment) • Personal care for all adults and children 166
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2.4 Contribution to services is determined on an individual basis by completion of a financial assessment form. This will take account of income, savings and other capital to work out how much each service user can afford to pay toward the cost of the services provided. Part of this assessment process will ensure that income is maximised and all appropriate benefits are being received. In North Ayrshire services users are supported by Money Smart to ensure benefits are maximised alongside their financial assessment for charges. Charges apply whether services delivered by the Health and Social Care Partnership directly, a provider or via a Direct Payment. 2.5 The Charging Policy is based on the following principles: • You will only be charged for the hours of care and support that you receive. • You will not be charged more than it costs to provide the service for which your charge has been assessed. • Where the charge is subject to a financial assessment, this will be based on your ability to pay, following an income maximisation assessment. • You will know how and why you are being charged. • You will be treated in a fair, transparent and equitable manner. 2.6 The below from Public Health Scotland illustrates the current framework for social care charging in Scotland: 167
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3. PROPOSALS Maximum Weekly Charge 3.1 The 2025/26 maximum charge is £120 and it is proposed to increase this to £126 (5% increase). 3.2 Community Alarms- Charges for community alarms are based on a flat rate weekly charge rather than being means tested per the charging policy. The proposed rates are given below: 168
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Ref Charge Description Basis Current Approved Charge (2025/26) £ Proposed Charge (2026/27) Basis of increase 2026/27 % 1 Community Alarms service - mainland (1st alarm in the household) Per week £6.85 £7.19 5.0% 2 Community Alarms service - mainland - weekly charge to HRA for sheltered housing properties Per week £6.85 £7.19 5.0% 3 Community Alarms service - Arran (1st alarm in the household) Per week £3.43 £3.60 5.0% 4 Community Alarms service - mainland (2nd alarm in the household) Per week £3.43 £3.60 5.0% 5 Community Alarms service - Arran (2nd alarm in the household) Per week £1.74 £1.83 5.0% 3.2.1 HRA Recharge – the recharge will be increased by 5% with the additional income being reinvested in the community alarm service to cover the additional costs of the digital community alarm service. 3.3 Day Care Charges for day care are means tested per the charging policy. The 2025/26 review of charges approved a higher increase for day care from 2025/26 to 2027/28. This was to reduce the gap between the cost of delivering the service and the contribution made to the service. 3.3.1 The proposed rates are given below: Ref Charge Description Basis Current Approved Charge (2025/26) £ Proposed Charge (2026/27) Basis of increase 2026/27 % 1 Day Care - Older People (purchased and provided) Per session £19.79 £23.75 20.0% 2 Day Care - Learning Disability (purchased and provided) Per session £20.61 £25.77 25.0% 3 Dirrans Centre Per session £19.79 £23.75 20.0% 4 Day Care and Dirrans Centre (charges to Other Local Authorities) Per week £280.79 £294.83 5.0% 169
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3.4 Financial Intervention Services – This is a flat rate charge. For new cases, no charge will be made for the first 12 weeks from commencement of Appointeeship. This will allow a sufficient period of time to identify and budget income and expenditure on behalf of the individual. A waiver of charges (on an individual basis) will be applicable for those with limited funds where their annual budget does not cover the charge. This is particularly in relation to care home residents with no capital whose income is subject to an assessed charge and personal allowance. Ref Charge Description Basis Current Approved Charge (2025/26) £ Proposed Charge (2026/27) Basis of increase 2026/27 % 1 Financial Intervention - Management of Service User Finances - residential service users Per week £3.50 £3.68 5.0% 2 Financial Intervention - Management of Service User Finances - community based service users Per week £5.50 £5.78 5.0% 3.5 Housing Support / Non-personal care inc Direct Payments – this is currently charged at £23.08 per hour and it is proposed to increase this in line with the increases to hourly rate to reflect the increase to the Living Wage. This charge is means tested per the Charging Policy and only applies to non-personal care aspects of an individual’s assessment. The proposed rates are: Ref Charge Description Basis Current Approved Charge (2025/26) £ Proposed Charge (2026/27) Basis of increase 2026/27 % 1 Care at Home Adults Per hour £23.08 £24.44 5.9% 2 Care at Home Older People per hour Per hour £23.08 £24.44 5.9% 3 Sleepover Per hour £15.45 £16.50 6.8% 4 Direct Payments - Personal Assistants Per hour £16.94 £18.02 6.4% 5 Direct Payments - Agency Rates Per hour £23.08 £24.44 5.9% 6 Direct Payments - Sleepovers Per hour £15.83 £16.89 6.7% 170
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3.6 Meals at home – a 5% increase is proposed for this service taking the charge from £3.89 to £4.08 per meal. This is a flat rate charge per the charging policy. Any additional income will be reinvested in the meals at home budget to reduce the current deficit that the service operates under. 3.7 Montrose House and Trindlemoss House – it is proposed to increase the weekly charge by the same percentage increase applied to the National Care Home Contract (NCHC). This is estimated as 5% pending confirmation of the 2026/27 NCHC rate. This charge is determined by an individual assessment and in line with separate guidance for Charging for Residential Accommodation Guidance (CRAG). The rates based on 5% are as follows but these rates will be updated when the NCHC rate 2026/27 is confirmed: Ref Charge Description Basis Current Approved Charge (2025/26) £ Proposed Charge (2026/27) Basis of increase 2026/27 % 1 Trindlemoss House - permanent placement Per week £1,471.78 £1,545.37 5.0% 2 Montrose House - permanent residential placement (capital below £34,999)* Per week £881.98 £926.08 5.0% 3 Montrose House - permanent residential placement (capital above £35,000) Per week £1,271.49 £1,335.06 5.0% 4 Montrose House - permanent nursing placement (capital below £34,999)* Per week £1,021.57 £1,072.65 5.0% 5 Montrose House - permanent nursing placement (capital above £35,000) Per week £1,471.78 £1,545.37 5.0% *25/26 threshold. 26/27 threshold TBC The figures highlighted in yellow are estimated pending the issuance of the Charging for Residential Accommodation Guidance (CRAG). This is usually issued by the Scottish Government in mid-February. 3.8 The HSCP publish annually a Social Care Charging Policy. The 2025/26 version of this can be found here Social Care Charging Policy - Non-residential and residential care services The policy for 2026/27 will be updated in line with the approved charges and will reflect any updates from the COSLA guidance. The charging process can be complex for families and individuals, particularly when accessing different services and types of support, therefore there is a requirement to clearly set out our policy, this includes sharing worked examples of how financial assessments are calculated. 171
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3.2 Anticipated Outcomes The charges proposed represent a fair and equitable approach which aligns with national policy and recognises the significant financial pressures for social care services and for some services will reduce the gap between the cost of providing the service and the contribution made by the service user. 3.3 Measuring Impact Charging income will be monitored as part of the 2026/27 budget monitoring reports presented to the IJB. 4. IMPLICATIONS 4.1 Financial The projected additional income of £0.120m will be incorporated into the financial plans for the IJB for 2026/27. 4.2 Human Resources None 4.3 Legal None 4.4 Equality/Socio-Economic An EQUIA has been completed, this recognises that charges will continue to be applied on an individual basis by the completion of a financial assessment form, that the policy is applied equally to all adult service users and will not impact on the level of care provided. Although increased charges may impact on the ability to pay, the policy maintains mitigations around the ability to pay, ensuring continuing to ensure income is maximised including benefits. 4.5 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. 4.6 Community Wealth Building None 4.7 Key Priorities The ability to deliver on our strategic priorities may be compromised due to the greater financial risk faced in 2026/27. This report will contribute to reducing this risk by identifying additional income which will contribute overall to service sustainability. 172
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5. CONSULTATION 5.1 The IJB Finance Working Group have considered the policy and approach for charging next year. The proposals have been shared with North Ayrshire Council finance colleagues to ensure these are considered as part of the budget setting process for North Ayrshire Council. Caroline Cameron, Director Author - Eleanor Currie, Principal Manager Finance, Section 95 Officer [eleanorcurrie@north-ayrshire.gov.uk] 173
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Appendix 1 Charge Description Basis Current Approved Charge (2025/26) Proposed Charge (2026/27) Indicative Charge (2027/28) Indicative Charge (2028/29) Basis of increase 2026/27 % Basis of increase 2027/28 % Basis of increase 2028/29 % Number of People Receiving a service Number of People charged Maximum Weekly Non-Residential Charge Per week £120.00 £126.00 £132.30 £138.92 5.0% 5.0% 5.0% 3 3 Care at Home Adults Per hour £23.08 £24.44 £25.66 £26.94 5.9% 5.0% 5.0% 418 270 Day Care - Older People (purchased and provided) Per session £19.79 £23.75 £28.49 £29.91 20.0% 20.0% 5.0% 239 190 Day Care - Learning Disability (purchased and provided) Per session £20.61 £25.77 £32.21 £33.82 25.0% 25.0% 5.0% 182 128 Day Care and Dirrans Centre (charges to Other Local Authorities) Per week £280.79 £294.83 £309.57 £325.05 5.0% 5.0% 5.0% - - Community Alarms service - mainland (1st alarm in the household) Per week £6.85 £7.19 £7.55 £7.93 5.0% 5.0% 5.0% Community Alarms service - mainland - weekly charge to HRA for sheltered housing properties Per week £6.85 £7.19 £7.55 £7.93 5.0% 5.0% 5.0% Community Alarms service - Arran (1st alarm in the household) Per week £3.43 £3.60 £3.78 £3.97 5.0% 5.0% 5.0% Community Alarms service - mainland (2nd alarm in the household) Per week £3.43 £3.60 £3.78 £3.97 5.0% 5.0% 5.0% Community Alarms service - Arran (2nd alarm in the household) Per week £1.74 £1.83 £1.92 £2.02 5.0% 5.0% 5.0% Meals on Wheels Per meal £3.89 £4.08 £4.28 £4.49 5.0% 5.0% 5.0% Care at Home Older People per hour Per hour £23.08 £24.44 £25.66 £26.94 5.9% 5.0% 5.0% 138 138 Financial Intervention - Management of Service User Finances - residential service users Per week £3.50 £3.68 £3.86 £4.05 5.0% 5.0% 5.0% 135 135 Financial Intervention - Management of Service User Finances - community based service users Per week £5.50 £5.78 £6.07 £6.37 5.0% 5.0% 5.0% 133 133 4,004 4,004 174
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The figures highlighted in yellow are estimated pending the issuance of the Charging for Residential Accommodation Guidance (CRAG). This is usually issued by the Scottish Government in mid-February. Charge Description Basis Current Approved Charge (2025/26) £ Proposed Charge (2026/27) Indicative Charge (2027/28) Indicative Charge (2028/29) Basis of increase 2026/27 % Basis of increase 2027/28 % Basis of increase 2028/29 % Number of People Receiving a service Number of People charged Dirrans Centre Per session £19.79 £23.75 £28.50 £29.93 20.0% 20.0% 5.0% 6 1 Sleepover Per hour £15.45 £16.50 £17.33 £18.20 6.8% 5.0% 5.0% Direct Payments - Personal Assistants Per hour £16.94 £18.02 £18.92 £19.87 6.4% 5.0% 5.0% 113 16 Direct Payments - Agency Rates Per hour £23.08 £24.44 £25.66 £26.94 5.9% 5.0% 5.0% 32 20 Direct Payments - Sleepovers Per hour £15.83 £16.89 £17.73 £18.62 6.7% 5.0% 5.0% 31 6 Blue Badge Charge for a 3 year period £20.00 £20.00 £20.00 £20.00 0.0% 0.0% 0.0% 4,608 4,608 Respite (for an individual's care need rather than to give the carer a break) Age 16-24 Per week £79.70 £83.69 £87.87 £92.26 5.0% 5.0% 5.0% - - Respite (for an individual's care need rather than to give the carer a break) Age 25 - 64 Per week £98.50 £103.43 £108.60 £114.03 5.0% 5.0% 5.0% 4 4 Respite (for an individual's care need rather than to give the carer a break) Age 65+ Per week £183.65 £192.83 £202.47 £212.59 5.0% 5.0% 5.0% 211 33 Trindlemoss House - permanent placement Per week £1,190.70 £1,250.24 £1,312.75 £1,378.39 5.0% 5.0% 5.0% 6 6 Montrose House - permanent residential placement (capital below £34,999)* Per week £825.94 £867.24 £910.60 £956.13 5.0% 5.0% 5.0% Montrose House - permanent residential placement (capital above £35,000) Per week £1,190.70 £1,250.24 £1,312.75 £1,378.39 5.0% 5.0% 5.0% Montrose House - permanent nursing placement (capital below £34,999)* Per week £948.59 £996.02 £1,045.82 £1,098.11 5.0% 5.0% 5.0% Montrose House - permanent nursing placement (capital above £35,000) Per week £1,378.13 £1,447.04 £1,519.39 £1,595.36 5.0% 5.0% 5.0% 7 7 175
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Appendix 1 Whistleblowing Quarter 2 Report 1 July – 30 September 2025 Agenda Item 10 177
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2 of 7 1. Introduction This report provides details of whistleblowing concerns raised across the organisation by staff and those who provide services on behalf of NHS Ayrshire & Arran. This report demonstrates our performance in the national key indicators as required by the INWO and includes key areas of whistleblowing handling, as well as highlighting outcomes and whistleblowing themes. Over time, this approach will illustrate trends and, more importantly, allow us to evidence necessary improvement and learning in response to the trends and themes demonstrated. 2. Learning, changes or improvements to service or procedures (KPI-1) System-wide learning, changes or improvements to services can be limited by the need to maintain confidentiality of individual whistleblowers. For each concern that is upheld, or partially upheld, an agreed improvement plan is put in place to address any shortcomings or apply the identified learning. The plan is agreed by the Commissioning Director for the investigation and delivery monitored through the department’s governance group, agreed with the Commissioning Director. The Corporate Governance Coordinator maintains oversight of progress against plans whilst actions transition from the whistleblowing process to business-as-usual action/improvement plans. The Whistleblowing Oversight Group receive updates on progress on a quarterly basis. There is one open improvement plan from a case raised in 2024/25, with the investigation concluded May 2025 and the investigation report and improvement plan approved by the Commissioning Directly by early August. Progress is being monitored through the Acute Services governance group with oversight from the Corporate Governance Coordinator. The table below shows the status of plans from cases raised in 2024/25. Year Stage Investig ations Investigations Improvement Plans Learning Plans Open Closed Open Closed Open Closed 2024/25 Stage 1 1 - 1* - - - - Stage 2 3 1 2** 1 - - - Table 1 *There was no improvement plan for the Stage 1 concern closed in Q3 2024/25. **There is no improvement plan for the Stage 2 concern raised in Q2 2024/25, as the unit in question has since been closed. The recommendations from the report are intended for Senior Management’s consideration should a similar unit be established in the future. 3. Experience of individuals raising concern/s (KPI-2) Individuals who raise concerns are given the opportunity to feedback on their experience of the whistleblowing process once the process has concluded. Any feedback received is viewed as learning and helps us to make improvements in our processes as appropriate. 178
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3 of 7 An anonymous feedback survey is shared with those involved in the whistleblowing process. This includes the individual who raised the concern and those involved with the investigation. As no concerns were closed in this quarter there is no feedback to report. 4. Level of staff perception, awareness and training (KPI-3) The Whistleblowing Policy and process continues to be highlighted to new staff as part of the Corporate Induction Programme and to newly appointed managers and leaders during training sessions. Monthly reports are produced to monitor completion of the Turas Whistleblowing eLearning modules. Table 2 shows the position for Q2 2025/26. Programme Completed Increase Current Staff % staff completed 30/06/2025 30/09/2025 An overview (Staff) 4885 5107 222 11731 43.5% For Line Managers 317 338 21 997 82.6% For Senior Managers 476 486 10 Table 2 Going forward communications will be refreshed via Daily Digest, eNews and through line managers to remind staff that completion of the relevant Turas Whistleblowing modules is mandatory for all line managers and senior managers and to encourage uptake and completion of modules. 5. Whistleblowing concerns received (KPI-4) Table 3 below shows the total number of concerns received in quarter 2 through the whistleblowing process and at what stage. Total concerns received Q2 Appropriate for WB Stage 1 Stage 2 2 2 - 2 Table 3 Two concerns were received in Q2: • Correspondence was received from the Independent National Whistleblowing Officer (INWO), advising that a complaint had been submitted regarding the NHSAA decision on concerns previously raised and an outcome that these did not meet the definition of whistleblowing. Following assessment, the INWO has determined that the concerns meet the definition of whistleblowing and fall within the scope of the National Whistleblowing Standards. As a result, the INWO has referred the matter back to NHSAA for progression under the whistleblowing procedure. The case is being progressed and Investigators have been appointed with HR support being identified to assist with the investigation. There has been ongoing engagement and support provided to the complainant. • The second concern was highlighted via a Confidential Contact who supported the Complainant to submit a statement for consideration. It was agreed that the 179
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4 of 7 concerns met the definition of whistleblowing and the matter is being progressed under Stage 2 of the whistleblowing process. Identification of an appropriate investigator is underway. No immediate risk was identified to patient safety in the concerns received in Q2, with no action required. Chart 1 below shows the number of concerns progressed as whistleblowing (Stage 1 and Stage 2) received in Q2 compared with Q2 in previous years. Chart 1 6. Concerns closed (KPI-5) This indicator reports on the numbers of concerns closed at Stage 1 and Stage 2 of the procedure as a percentage of all concerns closed. Table 4 shows that during Q2 2025/26 concerns raised at Stage 2 in Q2/Q3 of 2024/25 were concluded and formally closed during this reporting period. The Stage 2 concerns received in in Q4 2024/25 and this quarter are ongoing Year Quarter Stage Total Closed Ongoing % Closed against received 2024/25 Q2 Stage 2 1 1 - 100% Q3 Stage 1 1 1 - 100% Q3 Stage 2 1 1 - 100% Q4 Stage 2 1 - 1 2025/26 Q2 Stage 2 2 - 2 0% Table 4 7. Concerns outcomes (KPI-6) This indicator reports on concerns upheld, partially upheld and not upheld at each stage of the whistleblowing procedures as a percentage of all concerns closed in full at each stage. 0 1 2 3 2021/22 2022/23 2023/24 2024/25 2025/26 Number of WB concerns (Stage 1 & 2) Comparison Q2 2021/22 - 2025/26 St1 St2 180
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5 of 7 7.1 The definition of a Stage 1 concern - Early resolution is for simple and straightforward concerns that involve little or no investigation and can be handled by providing an explanation or taking limited action, within 5 working days. No stage 1 concerns were received during Q2. 7.2 The definition of a Stage 2 concern - are concerns which tend to be serious or complex and need a detailed examination before the organisation can provide a response within 20 working days. Year Stage Total Concerns Not Upheld Partially Upheld Fully Upheld 2024/25 Stage 2 3 1 33.3% 1 33.3% - - 2025/26 Stage 2 2 - - - - - - Table 5 Two Stage 2 concerns raised in Q2 and Q3 of 2024/25 were concluded and formally closed during this reporting period. One Stage 2 concern from Q4 2024/25 and two received in Q2 of 2025/26 remain ongoing. 8. Timeliness of handling whistleblowing concerns (KPIs 7, 8, 9 and 10) This section reports on: 8.1 KPI-7 The average time in working days for a full response at each stage of the whistleblowing procedure As the investigations into concerns received during this quarter are still ongoing, there is currently no data available to report against the relevant indicators. However, Table 6 presents the average response time for the two concerns closed in 2025/26 that were originally opened in 2024/25. Average response time in working days Stage 1 (5 days) 2024/25 Average time in working days for responses 13 No of cases closed at stage 1 within timescale as % 0% No of stage 1 cases extended 1 Stage 2 (20 days) Q2 2024/25 Average time in working days for responses 176 No of cases closed at stage 2 within timescale as % 0% No of stage 2 cases extended 3 Table 6 8.2 KPI-8 Number and percentage of concerns closed in full within set timescales As the investigations into concerns received during this quarter are still ongoing, there is currently no data available to report against the relevant indicators. 181
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6 of 7 8.3 KPI-9 and 10 Concerns where an extension was authorised Due to the complexity of the concerns received this quarter, the it is anticipated that the investigations will exceed the Stage 2 timescale of 20 working days. The individuals who raised the concerns have been informed of the need to extend the investigation period accordingly. 9. Whistleblowing themes, trends and patterns This section provides information on themes from whistleblowing concerns raised and will aid identification of any improvement priorities, and to progress learning in a targeted manner. 9.1 Breakdown by themes The Stage 2 concerns received in Q2 aligned with patient care/safety, workplace culture and service delivery as shown in Table 7. A culture of bullying has been indicated and will be considered as part of the investigation. Themes 2025/26 Q1 Q2 Patient Care - 1 Patient Safety - 1 Poor Practice - 1 Unsafe working conditions - 1 Fraud - 0 Changing or falsifying information about performance - 0 Breaking legal obligations - 0 Abusing Authority - 0 Table 7 9.2 Breakdown of concerns by service The two Stage 2 concerns received in Q2 relate to North Ayrshire Health and Social Care Partnership (NAHSCP). It is not possible to provide detail of the working area as this may impact the confidentiality of the whistleblower. 10. Independent National Whistleblowing Officer (INWO) 10.1 Referrals to the INWO A clear indicator of the satisfaction of those who raise concerns can be derived from the number of concerns that are escalated to the Independent National Whistleblowing Officer (INWO). As outlined in Section 5 of the report, during Q2 the organisation received correspondence from the Independent National Whistleblowing Officer (INWO) confirming receipt of a complaint about the organisation’s decision that concerns were not eligible for whistleblowing. The INWO concluded that the concerns meet the definition of whistleblowing and referred the matter back to the Board for progression under the whistleblowing procedure. 182
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7 of 7 10.2 INWO Stage 3 investigation reports Under the Standards, individuals who are dissatisfied with how their whistleblowing concerns have been investigated and addressed by Health Boards may escalate their complaint to the Independent National Whistleblowing Officer. The INWO conducts independent investigations and publishes findings, outcomes and key learnings on its website. INWO website. In this quarter no whistleblowing cases were escalated to the INWO. 11. Speak Up week Speak Up Week is a national annual engagement initiative launched by the INWO in 2022. This year’s event took place from 29 September to 3 October. Building on previous years and incorporating participant feedback, the INWO 2025 theme was "Listen, Act, Build Trust", highlighting the importance of fostering a culture of openness, responsiveness, and integrity. Due to resource constraints, this year’s Speak Up Week was delivered through digital engagement and communications channels. 183
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