Strategic Priorities
Priority 1: Prevention and Early Intervention
Investing in prevention and early intervention services is a key part of our strategy. By identifying those people most at risk of poor outcomes and providing effective early support we can prevent problems occurring or minimise the impact on the individual’s health and wellbeing.
The Edinburgh Wellbeing Pact is framed around the principles of mutuality and reciprocity, and these remain central to all the enactment activities which have been initiated to date. As part of our Community Mobilisation project, we have developed new ways to engage and fund the third sector, with an emphasis on community collaboration and assets.
The Edinburgh Pact and community mobilisation work undertaken in the last year has demonstrated how complex the structures and processes are in our commissioning space. The creation of the More Good Days Strategic Public Social Partnership (PSP) will provide a better way of moving forward with our shared narrative and allow incremental changes and developments to be made. Work with colleagues from procurement, commissioning and Health Improvement Scotland has helped to shape the proposal, and the PSP will enable us to be responsive and flexible to unallocated funding, as well as any additional or new allocations received. In June 2023 we held a session for partners to reflect on work to date and to think about how the PSP should be taken forward and what should be prioritised. The reflections suggested people want to work collaboratively drawing on the strengths of one another and be responsive to the needs of the community, and most of all, to listen to and be aware of the needs of our communities.
There are also a number of collaborations continuing to develop thanks to the extension of the current Health Inequalities Grant Programme to 31 March 2025 and the introduction of our innovative Capacity to Collaborate programme. Our support through Capacity to Collaborate for the innovative work of NeSSIE in the North West continues and the initial successes and learning has attached further funding from City of Edinburgh Council and Scottish Government. We continued to share ‘The nights are fair drawin’ in’ booklet we produced with our City of Edinburgh Council colleagues as part of their Warm and Welcoming Spaces initiative. The booklet contains helpful information and sources of help, which was distributed to libraries, community centres and arts venues across the city.
Our long-term conditions programme provides support to health and social care teams to improve care for people living with long-term health conditions, and those who are at risk of falls. There is a Long-Term Conditions Section on our website with information for people living with long term conditions, their families and carers.
We are currently reviewing and updating our Future Care Planning resources (previously Anticipatory Care Planning or ACP) in readiness for the forthcoming programme of work being led by Scottish Government, working with a range of delivery partners, to develop a national programme on future care planning. We have launched a Future Care Planning care homes online training and improvement package, and updated the Future Care Planning social care implementation guidance and resources.
We are also undertaking scoping work with the national Right Decision Service team on the potential to co-design and deliver a self-management and shared decision-making tool to provide a platform for digitising existing practitioner resources, Self-Management Practitioner Toolkit and Connect Here Directories, which offer easy access to practitioner tools to help with:
- gaining a shared understanding of what matters to people about improving their health and wellbeing
- working alongside people so that they are at the centre of decision-making which facilitates care and support that is right for them
- taking a values & strengths-based approach to enable connection with the right support to prevent crisis and have more good days.
In terms of digital support, we have successfully supported the implementation of remote blood pressure monitoring for use in 68 GP surgeries which is used by around 10,500 patients across Lothian. The National Blood Pressure Service was rolled out under a national agreement endorsed by the Scottish Government, supported by National Services Scotland, Technology Enabled Care (NSS TEC).
In collaboration with NHS Lothian colleagues, we developed a new Care Homes Falls and Frailty Education package which has been made available to all Care Homes as part of a quality improvement project. The aim of the ongoing project is to increase the confidence of care home staff in managing a person who has had a fall as well as knowledge of falls prevention and risk factors and improving reporting and recording of falls.
We have a responsibility for adult protection and our Chief Officer sits on the multi-agency Chief Officers Group for Public Protection that is responsible for all areas of public protection across Edinburgh. This group is supported by the Adult Protection Committee.
Following the publication of inspection into adult support and protection services in Edinburgh, we have been working to improve how we provide adult protection services. Between April 2023 and March 2024, there were 2,870 adult protection contacts across the city, compared with 2,851 last year (this is a restated figure following changes to how data are reported). This sustained level of adult protection referrals has put considerable pressure on our social work resources and impacted on our ability to respond to assessments for social care, as adult support and protection cases are prioritised. One of the changes that has been implemented is being able to distinguish between investigations that have been performed with and without investigatory powers. Since June 2023 when this change was made, a quarter of referrals (24.6%, 641) progressed to inquiry using investigatory powers.
At 26%, physical harm was the most common type of harm for those referrals which resulted in an investigation with investigatory powers, closely followed by financial harm (24%). Infirmity due to old age was the most common client group for those whose case was being investigated (32.9%) There were also 1,329 adult protection case conferences in the year, of which a third (29.9%) were initial case conferences.
Services supported through our EIJB Grants programme help to support early intervention and prevention through reducing social isolation, improving mental wellbeing, promoting healthy lifestyles including physical activity and healthy eating and building strong, inclusive and resilient communities. For example, through participation in community groups funded through the grants programme, B was supported to form friendships, increase his independence and create positive change in habits and lifestyle to became fitter and healthier.
B has a mild learning disability which means that he can’t read or write. Before attending sessions, he led a very sedentary and isolated lifestyle, staying indoors playing video games and watching films. However, he was keen to make lifestyle changes to improve his mood and continue his weight loss journey.
He started to come along to the Walking Adventures project in Moredun just before COVID ,when these sessions were suspended he joined Zoom catch ups and yoga sessions. When restrictions lifted and the walking sessions resumed, B continued to participate in all the available sessions. He greatly benefitted from meeting new people and the gentle outdoor exercise, forming friendships with other participants, who encouraged him to attend other activities such as the Goodtrees Garden Get Togethers, Move ‘n Groove sessions and cycling sessions at Bridgend Farmhouse, both of which he still attends.
This year, B has also begun to attend a programme of Social Cycling sessions with Edinburgh and Lothians Greenspace Trust and joined the new Ambling Adventures walking group in Holyrood Park, which have helped him get to know new parts of the city and whole new groups of people. Whether walking, cycling or jogging, he is now active every single day and recognises the difference that these changes have made to the quality of his everyday life.