Edinburgh Integration
Joint Board

Where possible/ appropriate proposals are focused on providing alternative ways in which people’s needs can be met to help ensure services are provided in the right place, at the right time and in the right way.

Positive

The savings proposals take a person-centred/human rights and assets based approach, and are guided by the values, priorities and guiding principles of the EIJB’s Strategic Plan

They will be an opportunity to help ensure positive choice, control and equality of outcomes for people.

In order to deliver savings and improvements required, all services cannot continue to be delivered as they currently are.  Those effected (either positively or negatively) will more likely be older people, people with disabilities and carers due to the inherent demographics of service users.

Service provision will be based on needs rather than people’s expectations, with priority given to the most vulnerable.

Links with community facilities, specialist support and advice services will continue, and opportunities will be maximised through connections with other workstreams including 3 conversations, the Edinburgh Pact and Transformation.

A move to more locality/ community-based models has the potential to align with the 20-minute neighbourhoods concept, with opportunities to receive care and support in locations that are easier and quicker to get to.

There is an opportunity to incorporate technological solutions to aid and provide flexible access to service delivery

Changes will provide a level of support which we can afford and so increase sustainability

Savings will be made through efficiencies and improved effectiveness, which may result in some people not receiving the same support to that which they currently receive or would expect to. Some services may also be delivered through a different approach.

Any change may cause anxiety, disruption and stress, particularly to those most vulnerable (including their unpaid carers), and a perceived sense of loss. This must be recognised and alleviated through considered planning and good communication.

There may be an increased ask of families, friends and unpaid carers (in particular women as a higher proportion of carers are women)  – links with the Carers Strategy will be established.  People’s support networks vary considerably and cognisance of this will be taken using a person-centred approach

Those with poor health literacy skills,  language difficulties and those with limited or no digital skills or with less online access will be considered whilst developing any technology enabled services or any move to a more self-managed care approach

Unpaid carers and women

Those with poor literacy skills; those for whom English is not as a first language, and those with less access to digital technology

There are likely to be positive and negative impacts for staff.

Positive

Clear policies and procedures will help support staff in their roles and provide a level of confidence.

Any shift in service provision/service re-prioritisation will require a degree of investment in skills development and support for staff which will may help increase staff morale.

Flexible approaches to working are likely to lead to digital investment to support the workface, enabling them to deliver services in a different way, providing opportunities for innovation and skills development.

The changes may bring additional stress and a sense of loss if they feel that they are not able to give the services which they think people are entitled to.

It is important that the rationale behind any service changes are clearly communicated to staff and that the required support, training, skills, policies and procedures are put in place.

Any change of service provision may also lead to increased levels of stress and anxiety for staff as they undertake challenging conversations with citizen (including people in receipt of services, families and carers).  Changes to service provision may lead to a rise in the number of complaints which can place a considerable time burden on staff.

The creation of more locality/community-based models aligns with the 20-minute neighbourhoods concept. There will be potentially less travel to a central location by people who can instead access services in the localities (leading to reduced emissions).

Staff are encouraged to travel sustainably, and where appropriate engage with people through Near Me, etc and other technological and digital options

Any changes proposed should support the NHS Lothian Sustainable Development Framework, CEC Sustainability Strategies and the Edinburgh 2030 net-zero carbon target.

Any changes in practice will provide an opportunity to implement change to culture and working practices and help support the Edinburgh 2030 net-zero carbon target

There could be an increase in staff travelling (leading to increased emissions) as they deliver more community-based support to people in their own homes instead of centrally.  Staff should be encouraged to travel sustainably

Changes will help ensure the long-term sustainability of services.

Any reduction in external commissioning may lead to a reduction in third sector and independent staffing. This impact should be limited as there is a recognised shortage of care staff across most organisations.