Performance
There are nine national health and wellbeing outcomes which have been set by the Scottish Government. Each Integration Joint Board (IJB) uses these outcomes to set their local priorities.
Underpinning the nine wellbeing outcomes sits a core suite of integration indicators, which all HSCPs report their performance against. These national indicators have been developed from national data sources to ensure consistency in measurement. The table below shows how the strategic priorities from our Strategic Plan contribute to these national outcomes and the national indicators associated with each priority.
Strategic priority | National outcomes this priority contributes to | National indicators |
Prevention and early intervention | Outcome 1: People are able to look after and improve their own health and wellbeing and live in good health for longer
Outcome 4: Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services |
Indicator 1
Indicator 7 Indicator 12 Indicator 16 |
Tackling inequalities | Outcome 5: Health and social care services contribute to reducing health inequalities | Indicator 11 |
Person-centred care | Outcome 3: People who use health and social care services have positive experiences of those services, and have their dignity respected
Outcome 7: People who use health and social care services are safe from harm |
Indicator 3
Indicator 4 Indicator 5 Indicator 9 Indicator 17 |
Managing our resources effectively | Outcome 9: Resources are used effectively and efficiently in the provision of health and social care services | Indicator 14
Indicator 20 |
Making best use of capacity across the system | Outcome 8: People who work in health and social care services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide | Indicator 6 |
Right care, right place, right time | Outcome 2: People are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community
Outcome 6: People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact of their caring role on their own health and wellbeing |
Indicator 2
Indicator 8 Indicator 13 Indicator 15 Indicator 18 Indicator 19 |
There are 23 indicators but four of them (indicators 10, 21, 22 and 23) have not yet been finalised for reporting and one (indicator 20) has not been reported since the pandemic due to data issues. National indicators (NI) 1 to 9 are based on the Scottish Health and Care Experience Survey (HACE) commissioned by the Scottish Government. The primary source of data for indicators 12 through 16 are Scottish Morbidity Records (SMRs), which are nationally collected discharge-based hospital records. For these indicators, calendar year 2022 is used as a proxy for 2022/23 due to the national data for 2022/23 being incomplete. We have done this following guidance issued by Public Health Scotland which was communicated to all Health and Social Care Partnerships. Using more complete calendar year data for 2022 should improve the consistency of reporting between Health and Social Care Partnerships.
Health and Care Experience Survey Indicators
National indicators (NI) 1 to 9 are based on the Scottish Health and Care Experience Survey (HACE) commissioned by the Scottish Government and sent randomly to around 5% of the Scottish population every two years. The next update is due in May 2024. The results of the most recent 2021/22 survey were reported in last year’s Annual Performance Report, reproduced for reference below. Reductions in almost all indicators since 2019/20 suggested the pandemic had affected both local and national responses.
National Indicator (NI) | 2021/22 Edinburgh | 2021/22 Scotland | 2019/20 Edinburgh | 2019/20 Scotland | 2017/18* Edinburgh | 2017/18* Scotland | 2015/16* Edinburgh | 2015/16* Scotland |
NI-1: Percentage of adults able to look after their health very well or quite well | 91.6% | 90.9% | 93.8% | 92.9% | 93.6% | 92.9% | 96.1% | 94.5% |
NI-2: Percentage of adults supported at home who agree that they are supported to live as independently as possible | 78.9% | 78.8% | 77.6% | 80.8% | ||||
NI-3: Percentage of adults supported at home who agree that they had a say in how their help, care or support was provided | 68.9% | 70.6% | 76.7% | 75.4% | ||||
NI-4: Percentage of adults supported at home who agree that their health and social care services seemed to be well co-ordinated | 64.8% | 66.4% | 72.6% | 73.5% | ||||
NI-5: Percentage of adults receiving any care or support who rated it as excellent or good | 77.4% | 75.3% | 82.2% | 80.2% | ||||
NI-6: Percentage of people with a positive experience of the care provided by their GP practice | 73.8% | 66.5% | 82.5% | 78.7% | 84.2% | 82.6% | 86.9% | 85.3% |
NI-7: Percentage of adults supported at home who agree that their services and support had an impact on improving or maintaining their quality of life | 79.2% | 78.1% | 83.2% | 80.0% | ||||
NI-8: Percentage of carers who feel supported to continue in their caring role | 30.4% | 29.7% | 33.0% | 34.3% | 34.8% | 36.5% | 36.6% | 40.0% |
NI-9: Percentage of adults supported at home who agreed they felt safe | 79.4% | 79.7% | 86.5% | 82.8% |
Source: Scottish Government HACE surveys *Please note that 2019/20 and 2021/22 results for indicators 1, 2, 3, 4, 5, 7 and 9 in the Core Suite Integration Indicator update may differ from those recently released in the HACE publication. In addition, results for some indicators are only comparable to 2019/20 and not to results in earlier years.
Indicator 11: Premature mortality rate
While we remain below the Scottish rate, the rate of premature mortality in Edinburgh has increased slightly over the past year, against a backdrop of improving performance across Scotland. Edinburgh remains in the top 50% of partnerships but moved from being ranked 11th to 14th out of the 32 areas. This represents a small number of additional deaths, but more work will be undertaken to understand why the trend in Edinburgh is not consistent with the wider country.

2018 | 2019 | 2020 | 2021 | 2022 | |
City of Edinburgh | 386 | 360 | 405 | 407 | 411 |
Scotland | 432 | 426 | 457 | 466 | 442 |
Indicator 12: Rate of emergency admissions for adults
Edinburgh has the lowest rate of emergency admissions in Scotland, and it is now the lowest it has been in at least six years, including during the pandemic. While admissions are affected by flow through the hospital system, 2022/23 also saw the lowest rate of A&E attendances by Edinburgh residents for many years.

The rate of emergency admissions varies across our localities, as per the table below:
2018/19 | 2019/20 | 2020/21 | 2021/22 | 2022* | |
City of Edinburgh | 8,566 | 9,482 | 8,554 | 8,571 | 7,472 |
Scotland | 12,284 | 12,529 | 10,957 | 11,632 | 11,155 |
North East | 9,134 | 10,235 | 9,128 | 8,887 | 7,596 |
North West | 8,962 | 9,963 | 9,272 | 9,230 | 8,369 |
South East | 7,303 | 8,001 | 7,058 | 7,374 | 6,244 |
South West | 9,065 | 9,946 | 8,940 | 8,897 | 7,751 |
Indicator 13: Rate of emergency bed days for adults
Edinburgh has the seventh lowest rate in Scotland and the rate is the lowest it has ever been, other than during the pandemic. The decrease in emergency bed days in the last year has been sharper for Edinburgh than Lothian or Scotland as a whole.

As with emergency hospital admissions, performance varies across our localities depending on demographics:
2018/19 | 2019/20 | 2020/21 | 2021/22 | 2022* | |
City of Edinburgh | 112,193 | 105,746 | 91,722 | 99,005 | 93,387 |
Scotland | 121,174 | 119,753 | 101,967 | 112,939 | 113,134 |
North East | 108,143 | 101,361 | 88,545 | 96,170 | 92,825 |
North West | 115,417 | 108,557 | 95,104 | 104,369 | 96,759 |
South East | 114,311 | 105,906 | 94,207 | 94,641 | 88,599 |
South West | 109,839 | 106,807 | 87,777 | 100,933 | 95,818 |
Indicator 14: Readmissions to hospital within 28 days of discharge
Edinburgh has seen a sharp drop in the rate of emergency re-admissions to hospital within 28 days of discharge and is now below the Scottish rate. The re-admissions rate improved across the whole of Lothian so further analysis will be undertaken alongside other Lothian HSCPs to understand the factors supporting this improvement and how it can be maintained.

Performance of this indicator varies by locality:
2018/19 | 2019/20 | 2020/21 | 2021/22 | 2022* | |
City of Edinburgh | 112 | 120 | 132 | 111 | 94 |
Scotland | 103 | 105 | 120 | 107 | 102 |
North East | 119 | 124 | 134 | 113 | 96 |
North West | 104 | 112 | 137 | 110 | 94 |
South East | 110 | 119 | 119 | 104 | 86 |
South West | 119 | 124 | 135 | 118 | 98 |
Indicator 15: Proportion of last 6 months of life spent at home or in community setting
The Edinburgh rate is now the highest it has ever been and is almost in line with the Scottish rate. Edinburgh is ranked 23rd but there are minimal differences between rates in different partnerships on this measure.

The breakdown by locality is as follows:
2018/19 | 2019/20 | 2020/21 | 2021/22 | 2022* | |
City of Edinburgh | 85% | 86% | 88% | 88% | 88% |
Scotland | 88% | 88% | 90% | 90% | 89% |
North East | 85% | 87% | 88% | 88% | 88% |
North West | 83% | 85% | 87% | 88% | 88% |
South East | 87% | 88% | 89% | 89% | 89% |
South West | 86% | 87% | 89% | 89% | 89% |
Indicator 16: Falls rate per 1,000 population in over 65s
Edinburgh has seen a drop in the rate of emergency admissions for falls in 2022 and the rate is the lowest it has been since changes were made to admission practices in Lothian (at the Edinburgh Royal Infirmary) in 2019. However, with a rate of 23.4, we are slightly above the Scottish figure of 22.1 and rank 21st out of all of the partnerships. The falls rate also improved across the whole of Lothian so further analysis will be undertaken alongside other Lothian partnerships to understand the factors supporting this improvement and how it can be maintained.

The breakdown by locality is as follows:
2018/19 | 2019/20 | 2020/21 | 2021/22 | 2022* | |
City of Edinburgh | 22 | 27 | 27 | 26 | 23 |
Scotland | 23 | 23 | 22 | 23 | 22 |
North East | 23 | 30 | 28 | 28 | 22 |
North West | 22 | 27 | 29 | 27 | 26 |
South East | 22 | 28 | 26 | 25 | 24 |
South West | 21 | 23 | 24 | 24 | 21 |
Indicator 17: Proportion of care services graded ‘good’ (4) or better in Care Inspectorate inspections
Following a reduction in inspection frequency due to the Covid-19 pandemic, 2022/23 saw the resumption of inspections across all sectors in the Partnership. The data for NI-17 comes from the Care Inspectorate and covers all registered services in Edinburgh, not just those that we run. The figure covers the latest inspection result for each registered service, even if the inspection took place before the referenced financial year. While the figure of 80% for 2022/23 represents the lowest figure for the partnership in five years, it is 5% above the figure for Scotland as a whole.

2018/19 | 2019/20 | 2020/21 | 2021/22 | 2022/23 | |
City of Edinburgh | 84.2% | 82.1% | 82.9% | 80.6% | 80.0% |
Scotland | 82.2% | 81.8% | 82.5% | 75.8% | 75.2% |
Indicator 18: Percentage of adults with intensive needs receiving care at home
The percentage of adults receiving personal care at home (rather than in residential care or HBCCC) has increased slightly in 2022, taking us above the Scottish average. This is likely linked to our progress in reducing our unmet need list for care at home.
Our performance in this indicator has improved compared to the previous year and is now at the highest level in the last six years. Our ranking compared to other partnerships improved from 20th to 12th out of 32 partnerships, moving us into the second quartile. We continue to work to shift the balance of care from hospital settings to the community, through our bed-based review and Home First approach.

2018 | 2019 | 2020 | 2021 | 2022 | |
City of Edinburgh | 61.8% | 61.4% | 59.0% | 61.6% | 65.7% |
Scotland | 62.1% | 63.0% | 63.0% | 64.6% | 63.5% |
Indicator 19: Number of days people aged 75+ spend in hospital when they are ready to be discharged
Edinburgh is one of only four partnerships that saw improved performance in delays in 2022/23. Our performance improved in each quarter so the results do not reflect the progress made throughout the year. In March 2022 we ranked 2nd for this indicator; in March 2023 we ranked 8th, with 1st being the worst performing.
The improvement in delay levels has been supported by our interim placement programme, which supported 174 people out of hospital saving 12,988 bed days in 2022/23, and work under way through our ‘One Edinburgh’ approach to home-based care is supporting increased efficiency and capacity gains in this sector. Our bed-based strategy will implement changes that support increased capacity in intermediate care and a move to a nursing model within our internal care homes. Ongoing work through the Home First project on implementing a Planned Date of Discharge will also support more proactive discharge planning.

2018/19 | 2019/20 | 2020/21 | 2021/22 | 2022/23 | |
City of Edinburgh | 1,621 | 1,175 | 579 | 1,388 | 1,310 |
Scotland | 793 | 774 | 484 | 748 | 919 |
Indicator 20: Percentage of total health and care spend on hospital stays where the patient was admitted in an emergency
NHS Boards have not been able to provide detailed cost information since 2019/20 due to changes in service delivery during the COVID-19 pandemic. As a result, PHS have not provided information for indicator 20 beyond 2019/20. PHS previously published information to calendar year 2020 using costs from 2019/20 as a proxy, but given the impact of the COVID-19 pandemic on activity and expenditure, PHS no longer consider this appropriate.
We also report on the performance indicators set by the Ministerial Strategic Group for Health and Community Care (MSG). These performance indicators give a view of how HSCPs are progressing against a range of whole system level measures. The performance indicators are largely based on hospital sector data due to routine availability of national data. While similar to some of the core indicators, these figures are calculated in slightly different ways so are not comparable.
Since the 2017/18 baseline was set, we are moving in the desired direction for all but one of these indicators: Mental Health Bed Days.
Indicator | 2017/18 Baseline total | Desired direction of travel | Latest available figures | Achieved Direction of travel | Latest Period |
A&E Attendances | 103,986 | ↓ | 99,264 | ↓ | 2022/23 |
Unplanned Admissions | 35,597 | ↓ | 30,741 | ↓ | 2022/23 |
Emergency Occupied Bed Days: | |||||
Acute | 330,759 | ↓ | 282,529 | ↓ | 2022/23 |
Geriatric Long Stay^ | 22,324 | ↓ | 18,063^ | ↓ | 2022/23 |
Mental Health | 122,841 | ↓ | 126,649p | ↑ | 2022/23 |
Delayed Discharges | 76,933 | ↓ | 70,208 | ↓ | 2022/23 |
Last 6 months of life spent in a community setting | 85.7% | ↑ | 88.4% | ↑ | 2021/22 |
Balance of Care: at home# | 95.6%# | ↑ | 96.0% | ↑ | 2021/22 |
^ Geriatric long stay unscheduled occupied bed days data is affected by SMR completeness issue.
p This data is provisional.
# This indicator is still under development and may change in future releases. The Balance of Care 2017/18 baseline figure has been updated since it was last published; it is now 95.5%