Health and Social Care Grants Review Stakeholder engagement event Thursday 26 April 2018

Agenda 1 Welcome 2.00 2 Grants review – our thinking so far 2.05 3 Break and your immediate questions 2.40 4 Over to you - round table discussions 3.00 5 Plenary – response to your immediate questions 3.40 6 Close 4.00

Purpose of the event To share the work done so far and our current thinking To get some dialogue going – we hope you will: give us your views challenge our thinking generate some new thinking to inform the next stage of development

How we deal with questions As we only have a limited amount of time in these sessions and want to make the best use of time possible: We are not going to allow time for questions after the presentation but will ask you to record any questions or immediate thoughts on one of the graffiti boards We will pick up the key themes from the questions in the plenary session Be clear that this is the first of the discussions and not the only chance to feed in.

How have we got here Existing grant programmes due to expire Strategic responsibility for health and social care moved to the IJB Need to ensure that any new grants programmes are aligned with IJB priorities and current challenges Reports to IJB in September and November 2017

Steering Group members Ann Duff – CEC Communications Claire Ironside - EAHP Ella Simpson – EVOC/SPG member Emma Gunter – CEC Contracts Graeme Henderson – Penumbra/ CCPS/ SPG member Maggie Deane - CEC Procurement Mike Massaro-Mallinson - EHSCP Locality Manager NW Moira Pringle – Chief Finance Officer IJB Moyra Burns - NHSL Health Promotion Neil Fraser - CEC Procurement Stephanie-Anne Harris – LCHIF/ SPG member Suzanne Lowden - EHSCP Strategic Planning Wendy Dale - EHSCP Strategic Planning

Context Roles of the: Why review Integration Joint Board (IJB) Health and Social Care Partnership (HSCP) City of Edinburgh Council (CEC) NHS Lothian (NHSL) Why review Current challenges Strategic Direction Impact of other pieces of work

Role of the IJB £s £s NHSL EIJB CEC Directions Directions £s £s CO NHSL and CEC delegate services and budgets to EIJB £s £s NHSL EIJB CEC EIJB produces strategic plan and issues directions to NHSL and CEC with associated budget and performance measures for delivery of services Directions Directions £s £s CO Strategic Planning Operational oversight Performance Management

Role of the HSCP EIJB CEC NHSL CO EHSCP Staff and budget Staff and Operational delivery Set aside services Hosted services

Doing more of the same won’t work   2018/19 2019/20 2020/21 2021/22 2022/23 £k Opening cost base 633,265 657,726 678,904 700,606 722,839 Projected increase in costs 23,341 21,206 21,712 22,233 22,854 Total projected costs 656,606 678,932 700,617 745,693 Projected income 624,065 625,236 626,288 627,719 629,150 Projected shortfall (£k) (32,541) (53,696) (74,329) (95,121) (116,544) Projected shortfall (%) 5.0% 7.9% 10.6% 13.2% 15.6%

Managing our resources effectively Making best use of capacity Strategic Plan Locality working Tackling inequalities Technology Living within our means Frail older people and those with dementia Mental health and substance misuse Prevention and early intervention Sustainable primary care Integrated workforce development Knowing our population better Long term conditions People living with disabilities Right care, right place, right time Person centred care Managing our resources effectively Making best use of capacity

Impact of other work Under Review

Current use of grants £ Addictions 97,073 Blood borne viruses 252,843 Disabilities 183,815 Mental Health 70,218 Older people 1,709,617 Unpaid carers 223,569 Health improvement 97,901 Health inequalities 1,755,686 Total 4,390,722

Locality split NW £810k NE £483k Citywide £2.25m SW £660k SE £196k

Priorities Inputs Reducing social isolation Strategic Plan priorities and actions Promoting healthy lifestyles, including physical activity and healthy eating Mental wellbeing Locality Improvement Plan outcomes Supported self-management of long-term conditions Information and advice – income maximisation Outline Strategic Commission-ing Plan outcomes Reducing digital exclusion Building strong, inclusive and resilient communities

Rationale for priorities Reflect the strategic plan, locality improvement plan outcomes and emerging priorities from OSCPs Relatively broad categories Reduces risk of grants programme not aligning with strategic commissioning plans Moves focus to people and their communities of place and interest but provides scope for current recipients

Principles

Any questions Please use the opportunity of a 20 minute break to: Grab a drink Write up any burning questions or immediate thoughts on the graffiti boards

Round table discussions Having heard all the information presented do you think we are on the right lines or have we missed anything? What opportunities does this review present for your organisation? How can we all work together on whole system change to deliver efficient and effective outcomes?

Key themes from questions pm Timescales on decisions Process Length of awards Splitting the pot – will allocations change, citywide – localities What will be funded (specifics) – Carers, Older people’s day services, Independent advocacy Efficiencies- why and when

Key themes from questions pm Core costs and funding for activities Difficult to respond to generalities Tendering Asset sharing Support for grant recipients What does grants programme shaped with third sector look like Citizen voice Leverage

Next steps Engagement events with partners 26 April 2018 Interim report to the Integration Joint Board 18 May 2018 Follow up engagement event 7 June 2018 Development of detailed proposals for new grants programme June/ July 2018 Second report to Integration Joint Board August 2018