2022/23 has been another challenging year for the health and social care sector throughout Scotland and this has been felt across our services in Edinburgh. Health, care and wellbeing continues to be affected by the aftermath of the pandemic, with an ongoing ‘cost of living crisis’ exacerbating existing inequalities.
The Edinburgh Integration Joint Board (EIJB), like others across Scotland, operates within a complex environment. Health and social care services are under pressure due to an ageing population, with increasing numbers of people living with long term conditions, whilst also facing a reducing working age population that is further impacted by challenges in workforce supply and pressure on budgets. This is ultimately leading to unparalleled challenges to the sustainability of our health and social care system. A refreshed EIJB Strategic Plan was put on hold until 2023/24 to allow us to target resources at the delivery of services and ensuring the smooth flow of patients through hospitals to free up beds to support our most vulnerable residents.
In this Annual Performance Report for 2022/23, we outline our challenges and achievements this year as well as our progress against the six Strategic Priorities in our Strategic Plan 2019-22, and against the Scottish Government’s National Health and Wellbeing Outcomes and associated indicators.
After a difficult few years responding to the pandemic and ensuing pressures across the system, we have seen positive improvements across a wide range of indicators covered in this report. 13 out of 15 indicators have seen an improved or steady ranking on benchmarked performance compared to last year and we remain in the top half of partnerships for 9 of the indicators with an update in this report, with improvements also seen in other areas. 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.
Despite these improvements and the positive stories of our service delivery and innovation shown throughout this report, there remains work to be done. The Care Inspectorate undertook two inspections of our services this year: Adult Support and Protection and Adult Social Care and Social Work. We welcome careful and ongoing scrutiny of our work and that of our partners to ensure that systems and practices are working effectively – and to make improvements when they are not. While these inspection reports highlight areas where we are getting it right, they also highlight key areas for improvement and reflect broader challenges that are common to health and social care partnerships across Scotland. In particular, the inspection reports highlighted concerns around the design, structure, implementation and oversight of key processes, social work workforce capacity, quality assurance and approaches to early intervention and prevention.
Despite the challenges we face, particularly in resourcing and recruitment, we need to build on our strengths – most obviously the commitment of our hard-working colleagues who give their all working in the Edinburgh Health and Social Care Partnership (EHSCP), supporting needs of those who have deeply complex and difficult lives. We have developed an improvement plan, approved by the EIJB in June 2023, to support frontline colleagues and respond to areas for improvement highlighted by the Care Inspectorate. Our priorities within this improvement plan are:
- A focus on early intervention, prevention and demand management
- Reducing waiting lists and improving access to services
- Best use of resources to meet demand and an improved structure
- Getting basic and key processes right
- Workforce – improving recruitment, retention and governance
- Better governance, including professional supervision, manager oversight and quality assurance.
Alongside this improvement plan, the EIJB approved a budget savings programme in June 2023 to enhance financial sustainability of our services within a difficult financial environment and demographic pressures. By using a person-centred approach, the EIJB can deliver better results for people more efficiently over the course of the strategy. In addition, through the use of stronger commissioning and an improved ‘digital front door’ for people looking to access services, the deficit reduction will be made through creating a modern service, fit for the future.
Our thanks go to all our staff, partners, unpaid carers and volunteers for their dedication and hard work through this difficult year and we look forward to continuing to support you to provide vital care and support to our most vulnerable citizens.