PAPER 4

East Ayrshire Health and Social Care Partnership

Report on East Ayrshire Strategic Planning Group

Development Seminar

Thursday 15th May, 2015

Auchinleck Resource Centre

Within the Joint Working (Public Bodies) Act, the term ‘strategic planning’ is used to describe

the process of undertaking a joint strategic needs assessment (needs, population dynamics

and projections, services activity, demand and gaps in provision) and the associated task of

using the output from this assessment for service planning the redesign of services to

delivery better personal outcomes and to address key policy priorities.

Partnerships are required under the Act to establish a Strategic Planning Group for the purpose of preparing and reviewing a Strategic Plan. It was agreed by East Ayrshire Shadow Integration Board that this would be the East Ayrshire CHP Forum, supported by the Officer Locality Groups.

This report provides the outcomes of the initial Strategic Planning Group Seminar held on the 15th May, 2014. This event provided an initial opportunity for the East Ayrshire partnership to reflect on the development of their strategic plan, with the shared aims outlined below:

To support all partners to develop a shared understanding of the process for the

development of East Ayrshire HSCP Strategic Plan

To engage with all partners in the shaping of the East Ayrshire HSCP Strategic

Plan

To explore how the Strategic Planning Group (SPG) is supported in relation to the

delivery of key services priorities, challenges and opportunities

To identify key areas for priority within the Strategic Plan

There were a total of 44 delegates at the event. All attendees were members of the CHP

Forum/Strategic Planning Group, and both the Children and Adult Officer Locality Groups

(attendance list attached at appendix 1).

The attendees were provided with a presentation, by Eddie Fraser, Director of Health and

Social Care for East Ayrshire, which set out the background and context in relation to

strategic planning both from a national and local perspective. Eddie outlined the suggested

timeframes for the development of the plan to attendees, including the preparation of the first

for early Autumn, followed by full engagement and consultation, with stakeholders.

A draft A&A framework for the strategic plan is attached at appendix two.

The session provided opportunity for colleagues to meet and discuss, within particular client

groups, the key service priorities in relation to their own services. This session included

attendees working across care groups and facilitated an opportunity for:

Discussion of priorities using care group approach

PAPER 4

Exploration of current work underway

Identification of additional work required

Feedback and responses from the workgroups are attached at appendix three

Following the discussion, the following next steps were agreed:

Agreement that locality working would form the basis of discussion for the next

meeting.

Agreement that further work would be developed around the care group model

within OLGs and sub groups. This would be discussed through the agendas of

the partnership groups to further inform the development of the plan

Further similar sessions would be agreed over the following months, which will

involve further engagement with service users and carers

These next steps will be discussed at the next CHP Forum/Strategic Planning Group

meeting planned for the 11th June 2014. Subsequent sessions will be arranged and

supported by the Officer Locality Groups.

PAPER 4

APPENDIX 1

Strategic Planning Group Event - 15.05.14

Attendee List

Forename Surname Title Organisation

1 Mary Ballantyne CHP Forum Member

2 Lyn Blain District Nurse NHS

3 Linda Chisholm Community Health Development Manager

4 Geoff Crow Housing Needs Officer EAC

5 Tammy Devlin Team Leader - Play and Early Intervention, Vibrant Comms EAC

6 Alison Findlay East Ayrshire Council EAC

7 Eddie Fraser Director of Health & Social Care EAC

8 Julie Gaw District Nurse NHS

9 Dorothy Gair Clinical Team Leader NHS

10 Kay Gilmour Head of Service Community Support EAC

11 Anne Gow Assistant Director of Nursing NHS

12 Diane Graham Person Centred Care Manager NHS

13 Marianne Hayward Head of Profession NHS

14 Shiona Johnston EA CHP Facilitator NHS

15 Eunice Johnstone Planning Manager NHS

16 Katie Kelly Strategic Manager, Vibrant Communities EAC

17 Jim Lyon Senior Manager Authority Wide Services EAC

18 Marion MacAuley Senior Manager EAC

19 Andrew MacDonald Planning and Development Manager, Social Works Services EAC

20 Isabel Marr Patient Services Manager NHS

21 Helen McGee Acting Head of Service Community Care EAC

22 Ailie McPherson OD East Ayrshire Council Facilitator

23 Kenny Milne Person Centred Care Officer NHS

24 Craig Murdoch Pharmacy Rep - CHP Forum

25 Rab Murray JIT Lead

26 Carolyn Paton Dietetic Lead Integrated Services - East NHS

27 Awfa Paulina GP NHS

28 Margaret Peck Performance Manager, Policy, Planning and Performance NHS

29 Denise Pentland Independent Sector

30 John Pickering Housing EAC

31 Margaret Phelps Corporate Officer Integration of Health & Social Care EAC

32 David Rowland Head of Primary Care NHS

33 Donna Sinforianie Adult Protection EAC

34 Joanne Sharp Health Care Manager NHS

35 Stephen Sheach Planning Manager, NHS

36 Anne Sinclair Manager Older People Vulnerable Adults NHS

37 Fiona Skilling General Manager - CVO

38 Louise Steel Speech and Language Therapy Service Lead NHS

39 Craig Stewart Clinical Service Manager NHS

40 Allan Thomas Lead Pharmacist - Public Health and Community NHS

41 Billy Thomson Fire and Rescue Service

42 Liam Wells Co-ordinator EAC

43 Rae Wilson Clinical Team Leader NHS

44 Kathleen Winter Child Health Co-ordinator NHS

PAPER 4

APPENDIX 2

Ayrshire and Arran Health and Social Care Partnerships - 10 year vision for integrated

services

1. Executive summary

2. Context

Future directions of public services in Scotland

Christie principles, prevention and early intervention etc.

Principles of co-production, personalisation, (SDS)

Context of time of scarcity

Key drivers summary

Case for change

What will success look like?

3) How will we do business together?

Vision for Integrated Services

Our Priorities

Summary of governance and accountability of Health and Social Care

Partnership

Our principles and values including:

Integration Principles

to improve wellbeing,

services integrated from the point of view of users,

meet differing user needs; anticipates those needs and prevents them arising

meet differing locality need

planned and led locally

engaged with the community

engaged with local professionals,

makes the best use of the available facilities, people and other resources.

Service Principles

Engaged with communities

Early intervention and Prevention focussed

Person centred and personalised,

Safe,

outcome focused,

PAPER 4

proactive,

flexible responsive and forward looking,

accessible,

resilience building

4) Locality Planning Approach

5) Communication and Engagement

Community, Stakeholder and user involvement including staff, carers,

groups of interest, individuals

6) Future models of care

Description of ambition (use Diagrams to illustrate)

7) Interface arrangements (diagram)

CPP

Acute services

Council services – Education and Skills, Housing etc

Commissioned services

Third Sector Interface

Independent Sector

8) Outcomes – How will we know if we have been successful?

Performance Matrix

Resource matrix

Community views

Health and Social Care Partnerships Section – Planning for thematic groups

This to include:

Children and Young People, Adults including disabilities, mental health, learning

disabilities; Addictions, Older People, Criminal Justice

Local Needs

Current models and resources

Future model, including partnership third and independent sectors

How will we deliver change?

PAPER 4

APPENDIX 3

CARE GROUP ONE - ADULTS & OLDER PEOPLE

KEEPING PEOPLE AT HOME – FUTURE PRIORITIES

Reduce hospital admissions of Older People i.e maintain older people in their own

homes.

Improve capacity of telecare/telehealth

‘e-health’ – e.g.

- EPR Access

- Clinic communities

- Referral

Continue development of single point of contact work – seamless access/service,

direct people to right services

Better use of prescribed medicines – waste, patient outcomes, budgetary, etc.

develop a range of community based alternatives for intermediate care

- Care homes

- Housing

IT services which talk to each partner services.

HOW - UNDERSTANDING AND RESPONDING TO NEEDS

Developing a clear understanding of health needs and locality level and tailoring

services to meet that need.

Address ongoing demographic changes including potential workforce

Develop locality planning

Improved integration of range of services available in locality.

- Such as Community Hospitals, Day facilities/GPs/DNs,

- Local teams to create local response teams

- Frail Older Peoples Pathway

SPOC

- Community services

- Hospital discharge

- Alternative to admission

- SW

- D/N (in/OOH)

- Voluntary Organisations

Establish service delivery hubs x 3??

Workforce plans

- Establish – common pathways

- Common outcomes

Integrating the efforts and endeavours of primary care services with other

community, third sector plus independent sector providers to remove duplication +

avoid gaps in service

Engagement of independent contractors with HSCP (localities and overall)

PAPER 4

WORKFORCE

Workload analysis to inform workforce – skills, skill mix, etc.

Identify priorities and support adequate training and development of staff.

Creating the capacity within the primary care workforce to deliver the service models

required to meet needs.

Resources to facilitate seamless provision of care from Acute – community

Workforce appropriately trained, looking at skill mix

Improve GP access

Recruitment

Use of ANP

Specialities in the community

Development and support for teams working within new localities or across localities.

Open access to parallel service

- Physio

- Mental health

- Podiatry

Early workforce intervention

Prevention and protection

COMMUNITY WELLBEING

Building Individual resilience and responsibility

Adopt a fairer charging policy for services in supported accommodation

Continue to promote/invest in giving older people opportunities to stay healthy and

independent

To enable older people to live safely in their own homes for as long as possible.

- Responsive services

- Appropriate housing

- Addressing health needs

Whole system approach health eg. To weight management – both obesity – under

nutrition

- Shift balance of care – community

Better integration of RSL supported accommodation into EAC services

Empower Pts and families promote self management

Pharmaceutical services that meet the needs of the populations

PAPER 4

Feedback from Group 2 - Children and Families

The initial discussion focused on principles and approaches that would underpin the

priorities;

Engagement

Extensive public involvement and ensure service users voice is heard not only at

group but also individual

Develop arrange of engagement models – one size does not fit all communities and

do not assume that existing approaches are the only way , need to revise and

develop new approaches ( e.g. care leavers strategy and approaches to

engagement )

Extensive community engagement with third sector- including groups who are not

involved in third sector interface

Work with seldom heard groups- offenders, children and young people and working

with families in their own communities

Need to build capacity in communities and reduce dependency

Develop sustainability and utilising multi agency resources and financial stability in

delivering services

Need to map existing delivery across partners, what we are doing now

Locality focus- need to evidence and what that would look like

Early intervention and prevention

Parenting support, ante natal, attachment focus, schools, addiction , mental health

and home visiting

Universal service to children, young people and their families

Joined up intervention in communities

Shifting the balance from specialist AHP services to universal services whilst

maintaining access to specialist AHP services

Proportional universalism

Workforce Support and Development

Multi agency approach around culture and values

Financial inclusion and tackling inequalities

Universal timeline of support to improve health and wellbeing of pre 5 children,

school age children and young people in partnership

Child poverty- support for families into work, youth unemployment, living wage and

workforce

Impact of poverty on poor health and social outcomes

Other issues; Partnership approach with parents e.g. SDS

PAPER 4

PRIORITIES

Recognised that the current priorities being addressed by OLG and sub groups are still

relevant

Corporate Parenting

Positive emotional wellbeing

Child protection and safeguarding

Facilitating recovery orientated approaches

SHANARRI wellbeing indicators

GIRFEC approach with partners

Common ethos and approach – multi agency

Question: What would leads require as additional support? Discussion focused around

policy, strategy and approach to further develop the agenda

Noted- need to consider how we engage with communities recognising that CLA Plans are

being developed and the existing methods we use do not have the reach we may require.

The challenge of connecting service locality models with new hub approach noting that this

is Council and community planning approach but still needs to connect with community and

health.

Some new developments;

Council -Volunteer Framework

Council -Community engagement and consultation strategy

Positive Destinations

Pre-birth to 8 Commissioning Strategy ( partnership)

Third sector Strategy- wider engagement

Workforce /OD Strategy ( framework and principles on pan Ayrshire and partnership

delivery model) should include learning and development for all partners, recognise

that some partners on OLG not in partnership but still require support e.g. early

years, Vibrant Communities, CJA

Volunteers- need to manage, support and value their contribution, not seen as

duplicate workforce

Need to engage with community orgs not involved in third sector

Maintain and build partnership relationship with partners not in HSC partnership

Resource framework for partnership and non partnership services

Learning from experience of children and families OLG – developing new

initiatives/working without additional resources- utilising existing resources

Understanding needs and matching to localities

Balancing evidenced need and demand – resource reallocation and prioritisation to

greatest need

EYC model of change could learn from and use the approach

PAPER 4

Existing Plans and Strategies

Children and Young People

ADP Plan National –local delivery plan

Keys to Life (National) National –local delivery plan

Corporate Parenting and Care Leavers Multi agency

Child Protection Strategy Multi agency

Carers (Young Carers) Strategy Multi agency

Violence Against Women Action Plan Multi agency

GIRFEC Delivery Plan Multi agency

Financial Inclusion Multi agency

Sensory Impairment Multi agency

Advocacy Multi agency

Homelessness Improvement ( Housing) Strategy

Council led partnership delivery

Children and Young People Service Plan Council

Third Sector Interface- business plan 4 areas of work

Third sector

Child Health strategy NHS led partnership delivery

Improving Health and Wellbeing (draft) NHS led partnership delivery

Oral health NHS led partnership delivery

Health Weight NHS led partnership delivery

Tobacco NHS led partnership delivery

Infant Nutrition NHS led partnership delivery

Maternity NHS led partnership delivery

Sexual Health NHS led partnership delivery

Palliative Care NHS

Public Health Business Plan NHS

HP Local Delivery Plan NHS

PAPER 4

Feedback from Group 3 – Mental Health , Addictions, Learning Disabilities

Priorities

(Maslow) – Address basic needs of people. First need to be safe/housed to then be

able to address greater control for the individual which in turn motivates them to want

to look after themselves

Create a feeling of belonging/social connectedness thereby reducing risk to the

individual – do so through community asset based approach

Create network/communities (ground in localities) in order to deliver services people

need and want and empower them (link people to each other and Professionals to

each other) – the service users knows best

Be good employers/lead by example/value our own people – recognising the need to

create jobs that are meaningful

All priorities acknowledged to be at the top of the triangle and relevant to all three

groups here and indeed the other two groups in the room.

Drawn from wider group priorities which covered

Have the right people in the right place at the right time providing the right support (–

consider CLAPs – who is in localities and employ the right people)

Suitable housing provision – in the right place of the right type (support people to

avoid homelessness by having sustainable tenancies)

In all of this sure equality/equity of access (not necessarily the same but fairly

targeted- are vulnerable groups being looked after- use the data. Also reach those

who will not choose to engage) ensure no inverse care (so the person who shouts

the loudest doesn’t always get what they want

Access to appropriate nutritional advice timeously

Create professional networks so that professionals know who to refer people to and

how to do that (signpost). Also in that upskill professionals so that they feel able to

help themselves without referral where appropriate e.g. Community pharmacists can

feel isolated)- More integrated service delivery/shared responsibility

Increase communication and “integrated hub teams” Pharmacy/GPs/Teachers etc

Appropriate information sharing between parties to achieve org outcomes/SOA and

Strategic Plans

Info share re Fire risk on discharge from hospital so Fire Service can act – reduce no

of dwelling fires and associated fire casualities through effective and appropriate fire

safety in the home

More partnership working

Ensure integrated income maximisation

Tackle stigma – community and workers. Engage drug users with their local

community/support “See me”- reduce stigma at work

Focus on the individual (SDS) – health and social care responses – power back to

the individual

Listen to people’s really issues and follow up to address them

Develop cross cutting approaches (to drug and alcohol use)

More/better data sharing and systems to support this

PAPER 4

Work with communities to identify what they feel the health priorities are and

empower them – listen to our communities

Its about being safe and being connected to create wellbeing

Take account of all of this in discharge process from hospital

Reduce barriers that present themselves (say yes?) PVG example

Education around healthy lifestyles and wellbeing really important

Support carers and the wider community to provide natural supports

Could we have one form for commissioning used by all to save the stiory being told

over and over

Culture shift to include valuing the person/asset based/ give over control/consider

early intervention and prevention/

Change culture so that healthy eating is the norm

Ensure all outcomes link to/match are congruent with National Outcomes (or we

shouldn’t be doing it)

Ensure Fund and resource the right things

Put in other supports – make it easy to cycle

PAPER 4

Existing Plans and Strategies

Mental Health Addictions Learning Disabilities

National Mental Health Strategy* ADP Plan Partnership in Practice Agreement

MH Delivery Action Plan Keys to Life (National)*

Carers (Young Carers) Strategy* Commissioning Plan Autism Strategy

Health and Wellbeing Strategy (draft)* Road to Recovery (National)

Choose Life (Strategy) Scotland’s Alcohol Strategy

Dementia Strategy (National)

Physical Health and Mental Wellbeing Plan*

Adult Protection Strategy*

Vibrant Communities Action Plan*

SDS 10 year Strategy (National)*

Child Protection Strategy*

Autism Strategy

*Spans all three areas

Everything done must be working towards achieving the National Outcomes

Can we streamline any of our plans?

PAPER 4

Going Forward. Key areas the group wish to see addressed

Equity of access. Avoid inverse care. Monitor and challenge

Community asset-based approach key to service delivery of future but

ensure do use demographics to ensure plan based on future need not current

e.g. older people v younger people – see Census

Take due regard of rural v urban need employability key to addressing

dependency culture NHS/Council should ensure their own policies support

good practice here

Must address key issue of data sharing

Make clear evidence based decision making – big picture thinking – consider

localities in this and need to ensure data is up-to-date. Look to improve data

captured and shared

Build networks to identify who to communicate with and how (online forums)

Put in place some governance around networks – but keep it simple.

Include Communities in the networks and communication arrangements