1. health and fitness

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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:
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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:
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Discussion of priorities using care group approach
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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:
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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.
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APPENDIX 1
Strategic Planning Group Event - 15.05.14
Attendee List
1
2
3
4
Forename
Mary
Lyn
Linda
Geoff
Surname
Ballantyne
Blain
Chisholm
Crow
Title
CHP Forum Member
District Nurse
Community Health Development Manager
Housing Needs Officer
Team Leader - Play and Early Intervention,
Vibrant Comms
East Ayrshire Council
Director of Health & Social Care
District Nurse
Clinical Team Leader
Head of Service Community Support
Assistant Director of Nursing
Person Centred Care Manager
Head of Profession
EA CHP Facilitator
Organisation
5
6
7
8
9
10
11
12
13
14
Tammy
Alison
Eddie
Julie
Dorothy
Kay
Anne
Diane
Marianne
Shiona
Devlin
Findlay
Fraser
Gaw
Gair
Gilmour
Gow
Graham
Hayward
Johnston
15
16
17
18
Eunice
Katie
Jim
Marion
Johnstone
Kelly
Lyon
MacAuley
NHS
EAC
EAC
EAC
Phelps
Rowland
Sinforianie
Sharp
Planning Manager
Strategic Manager, Vibrant Communities
Senior Manager Authority Wide Services
Senior Manager
Planning and Development Manager, Social
Works Services
Patient Services Manager
Acting Head of Service Community Care
OD East Ayrshire Council
Person Centred Care Officer
Pharmacy Rep - CHP Forum
JIT Lead
Dietetic Lead Integrated Services - East
GP
Performance Manager, Policy, Planning and
Performance
Independent Sector
Housing
Corporate Officer Integration of Health & Social
Care
Head of Primary Care
Adult Protection
Health Care Manager
19
20
21
22
23
24
25
26
27
Andrew
Isabel
Helen
Ailie
Kenny
Craig
Rab
Carolyn
Awfa
MacDonald
Marr
McGee
McPherson
Milne
Murdoch
Murray
Paton
Paulina
28
29
30
Margaret
Denise
John
Peck
Pentland
Pickering
31
32
33
34
Margaret
David
Donna
Joanne
35
36
37
Stephen
Anne
Fiona
Sheach
Sinclair
Skilling
Planning Manager,
Manager Older People Vulnerable Adults
General Manager - CVO
NHS
NHS
38
39
40
41
42
43
44
Louise
Craig
Allan
Billy
Liam
Rae
Kathleen
Steel
Stewart
Thomas
Thomson
Wells
Wilson
Winter
Speech and Language Therapy Service Lead
Clinical Service Manager
Lead Pharmacist - Public Health and Community
Fire and Rescue Service
Co-ordinator
Clinical Team Leader
Child Health Co-ordinator
NHS
NHS
NHS
NHS
EAC
EAC
EAC
EAC
NHS
NHS
EAC
NHS
NHS
NHS
NHS
EAC
NHS
EAC
Facilitator
NHS
NHS
NHS
NHS
EAC
EAC
NHS
EAC
NHS
EAC
NHS
NHS
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APPENDIX 2
Ayrshire and Arran Health and Social Care Partnerships - 10 year vision for integrated
services
1. Executive summary
2. Context
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Future directions of public services in Scotland
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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
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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
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Engaged with communities
Early intervention and Prevention focussed
Person centred and personalised,
Safe,
outcome focused,
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proactive,
flexible responsive and forward looking,
accessible,
resilience building
4) Locality Planning Approach
5) Communication and Engagement
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Community, Stakeholder and user involvement including staff, carers,
groups of interest, individuals
6) Future models of care
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Description of ambition (use Diagrams to illustrate)
7) Interface arrangements (diagram)
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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?
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Performance Matrix
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Resource matrix
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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
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Local Needs
Current models and resources
Future model, including partnership third and independent sectors
How will we deliver change?
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APPENDIX 3
CARE GROUP ONE - ADULTS & OLDER PEOPLE
KEEPING PEOPLE AT HOME – FUTURE PRIORITIES
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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
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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)
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WORKFORCE
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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
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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
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Feedback from Group 2 - Children and Families
The initial discussion focused on principles and approaches that would underpin the
priorities;
Engagement
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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
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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
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Multi agency approach around culture and values
Financial inclusion and tackling inequalities
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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
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PRIORITIES
Recognised that the current priorities being addressed by OLG and sub groups are still
relevant
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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;
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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
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Existing Plans and Strategies
Children and Young People
ADP Plan
Keys to Life (National)
Corporate Parenting and Care Leavers
Child Protection Strategy
Carers (Young Carers) Strategy
Violence Against Women Action Plan
GIRFEC Delivery Plan
Financial Inclusion
Sensory Impairment
Advocacy
Homelessness Improvement ( Housing)
Strategy
Children and Young People Service Plan
Third Sector Interface- business plan 4 areas
of work
Child Health strategy
Improving Health and Wellbeing (draft)
Oral health
Health Weight
Tobacco
Infant Nutrition
Maternity
Sexual Health
Palliative Care
Public Health Business Plan
HP Local Delivery Plan
National –local delivery plan
National –local delivery plan
Multi agency
Multi agency
Multi agency
Multi agency
Multi agency
Multi agency
Multi agency
Multi agency
Council led partnership delivery
Council
Third sector
NHS led partnership delivery
NHS led partnership delivery
NHS led partnership delivery
NHS led partnership delivery
NHS led partnership delivery
NHS led partnership delivery
NHS led partnership delivery
NHS led partnership delivery
NHS
NHS
NHS
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Feedback from Group 3 – Mental Health , Addictions, Learning Disabilities
Priorities
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(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
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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
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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
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Existing Plans and Strategies
Mental Health
National Mental Health Strategy*
MH Delivery Action Plan
Carers (Young Carers) Strategy*
Health and Wellbeing Strategy (draft)*
Choose Life (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
Addictions
ADP Plan
Commissioning Plan
Road to Recovery (National)
Scotland’s Alcohol Strategy
*Spans all three areas
Everything done must be working towards achieving the National Outcomes
Can we streamline any of our plans?
Learning Disabilities
Partnership in Practice Agreement
Keys to Life (National)*
Autism Strategy
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Going Forward. Key areas the group wish to see addressed
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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