Introduction

The EIJB was established in 2016 to bring together the planning and operational oversight for a range of NHS and Local Authority services. This was intended to improve overall health and wellbeing through the delivery of more efficient and effective health and social care services.

This performance report sets out our progress against the strategic priorities within the EIJB Strategic Plan 2019-22, which remains extant and is available online. The content in this report covers the financial year April 2022 to March 2023 unless otherwise stated. An update to the EIJB Strategic Plan was delayed as we responded to post-pandemic systems pressures and our response to recent inspections. The refreshed EIJB Strategic Plan is expected to be published in late 2023.

The EHSCP is responsible for providing integrated services through the operational delivery of the EIJB’s strategic plan. Its workforce is made up of staff employed by both the City of Edinburgh Council and NHS Lothian, and our Chief Officer is accountable to the Chief Executives of both the City of Edinburgh Council and NHS Lothian.

We organise our community health and social care services in Edinburgh around four localities: South East, South West, North East and North West. The management of most community health and social care services is carried out in these localities, including assessment and care management, home care, day centres for older people and care homes in Edinburgh.

Our major change projects are now collectively referred to as Innovation and Sustainability. The Innovation and Sustainability Portfolio includes some of the key pieces of work that were previously part of the transformation programme, including Home First, Three Conversations and the Edinburgh Wellbeing Pact, which are outlined in this report. However, it also focuses on ensuring that services are sustainable in the longer term. To be sustainable, we need to deliver services within our budget, but we also need to address the challenge of increasing demand for health and social care services and ensure that we can continue to attract and retain a skilled and capable workforce.

Edinburgh is one of the largest health and social care partnerships in Scotland, with a population of 526,470 as of July 2021. 81,277 residents were aged 65 or over, with this age group projected to increase the most over the coming years. Edinburgh is also the wealthiest city in Scotland, with 80.9% of the working age population in employment. 34.7% of the economically inactive population within the city are students, and 19% look after others.1 However, 15% of the population, and as many as 20% of children, live in relative poverty. This poverty is spread throughout the city, with two thirds of those living in poverty not living in areas described as deprived. The majority of those in poverty are in employment. An overview of our localities is provided here and our joint strategic needs assessment (JSNA) provides more detail on the population and demographics of Edinburgh.

North East

  • 125,188 people live in the North East locality1
  • 50.8% are female and 49.2% are male
  • 15.1% are aged under 18, 71.6% are 18-64 and 13.3% are over 65
  • 21.2% of people lived in the least deprived SIMD quintile, and 18.2% lived in the most deprived quintile2
  • Life expectancy at birth is 80.6 years for women and 76 for men1
  • 36,392 average home care hours per week between January and March 2023
  • 1,564 were receiving home care at the end of March 2023
  • 18 GP practices3

North West

  • 148,992 people live in the North West locality1
  • 51.6% are female and 48.4% are male
  • 19.7% are aged under 18, 62.6% are 18-64 and 17.7% are over 65
  • 50.3% of people lived in the least deprived SIMD quintile, and 9.1% lived in the most deprived quintile2
  • Life expectancy at birth is 83.4 years for women and 79.6 for men1
  • 30,886 average home care hours per week between January and March 2023
  • 1,616 people receive were receiving home care at the end of March 2023
  • 18 GP practices3

South East

  • 138,730 people live in the South East locality1
  • 52.4% are female and 47.6% are male
  • 14% are aged under 18, 71.5% are 18-64 and 14.5% are over 65
  • 49.5% of people lived in the least deprived SIMD quintile, and 8.8% lived in the most deprived quintile2
  • Life expectancy at birth is 82.5 years for women and 78.1 for men1
  • 26,935 average home care hours per week between January and March 2023
  • 1,300 people were receiving home care at the end of March 2023
  • 18 GP practices3

South West

  • 113,560 people live in the South West locality1
  • 49.7% are female and 50.3% are male
  • 17.6% are aged under 18, 66.4% are 18-64 and 16% are over 65
  • 40.8% of people lived in the least deprived SIMD quintile, and 12.9% lived in the most deprived quintile2
  • Life expectancy at birth is 83.2 years for women and 78.8 for men1
  • 31,757 average home care hours per week between January and March 2023
  • 1,358 people were receiving home care at the end of March 2023
  • 16 GP practices3
[1] The Scottish Public Health Observatory (ScotPHO)

2 PHS LIST Locality Profiles

3 National Primary Care Clinicians Database (NPCCD), Public Health Scotland

In the Performance section of this Annual Performance Report, we report progress against the National Indicators set by the Scottish Government and Ministerial Strategic Group for Health and Community Care (MSG) indicators.

13 out of 15 indicators with an update this year have seen an improved or steady ranking on benchmarked performance compared to last year and we remain in the top half of partnerships for nine (60%) of the indicators, with improvements also seen in other areas. Our benchmarked performance is shown in the table below, including our quartile position and the change in our ranking compared to last year.

In particular, we have seen positive movement in our levels of bed days spent in delay for over 75s this year. Edinburgh is one of only four partnerships that saw improved performance in delays in 2022/23, with a 6% reduction in Edinburgh compared to a 23% increase nationally, although challenges remain to reduce our level of delays to sustainable levels.

For the areas that have not seen improvement this year, we remain above the national average in both indicators and the reduction in the actual rate is small.

Core Indicator Time Period Quartile Change in rank from previous year
NI-11 Premature mortality rate 2022 2
NI – 12 Emergency admission rate (per 100,000 population) 2022 1
NI – 13 Emergency bed day rate (per 100,000 population) 2022 1
NI – 14 Emergency readmissions to hospital within 28 days of discharge (rate per 1,000 discharges) 2022 2
NI – 15 Proportion of last 6 months of life spent at home or in a community setting 2022 3
NI – 16 Falls rate per 1,000 population aged 65+ 2022 3
NI-17 Proportion of care services graded ‘good’ (4) or better in Care Inspectorate inspections 2022/23 2
NI – 18 Percentage of adults with intensive care needs receiving care at home 2022 2
NI – 19 Number of days people spend in hospital when they are ready to be discharged (per 1,000 population) 2022/23 4
MSG1.a Rate of A&E Attendances
(lowest rate = Quartile 1)		 2022 2
MSG1.b 4-hour Performance 2022 4
MSG2 Rate of Emergency Admissions
(lowest rate = Quartile 1)		 To Oct-22 1
MSG3a. Unscheduled Bed Days (Acute): To Oct-22 1
MSG3c. Unscheduled Bed Days (MH): To Sep-22 4
MSG4 Delayed Discharge Bed Days: To Mar-23 3

Source: Public Health Scotland Notes: Quartile Trend: The Quartile shown denotes which quartile the City of Edinburgh partnership was in during the time period noted. The arrows indicate the change in the City of Edinburgh’s position relative to the other partnerships, between the 12-month time period noted and the previous 12 months.