Integrated Impact Assessments – EHSCP restructure phase two
EHSCP Restructure Phase 2 – Assessment and Care Management, Mental Health Officer, Mental Health, Learning Disabilities and Substance Use
Phase 1 was implemented in July and August 2024 with the appointment of Heads of Service, Service Managers and professional leads. Interim arrangements were planned to ensure services were safely managed until Phase 2 could be implemented.Phase 2 planning has been underway since September 2024 with a
Project Team reporting to an Oversight Group. Both groups have full involvement of NHS Partnership, Council Unions and HR.
The Oversight Board has agreed in principle that in light of difficulties in interim management arrangements in Mental Health, Substance Use and Learning Disabilities and Assessment and Care Management engagement and consultation on these areas should take place earlier than other services in Phase 2.
These difficulties have led to spans of control for managers that are too wide to be operationally effective and weaknesses in professional management and leadership.
It is proposed to create Team Leader posts within Assessment and Care Management, Mental Health Officer and Mental Health, Learning Disabilities and Substance Use to strengthen operational and professional management in these services.
As the legislation for locality working still applies, the partnership will ensure that working at locality level continues in a number of ways.
N/A, this is an internal management review, engagement sessions held with internal colleagues.
27 November 2024
Identify facilitator, Lead Officer, report writer and any partnership representative present and main stakeholder (e.g. NHS, Council)
| Name | Job Title | Date of IIA training |
|---|---|---|
| David Small | SRO – Lead officer | |
| Gosia Szymczak | Project Manager – facilitator | January 2020 |
| Matt Kennedy | Head of Service Assessment and Care Management and acting Principal Social Work Officer | |
| Anna Duff | Head of Service Mental Health, Learning Disabilities and Substance Use | 2019 |
| Heather Gillfillan | Partnership Lead | |
| David Harrold | Branch Secretary Unison | |
| Richard Cawker | Trade Union Representative Unite | Trade Union Representative Unite |
| Eleanor Kay | HR Relationship Lead (Council) | |
| Siobhan Murtagh | Senior HR Consultant (Council) | 28 October 2021 |
| Louise Morgan | Employee Relations Manager (NHS) | |
| Sara MacDonald | Senior Accountant (Council) | |
| Katie Feehan | Finance Manager (NHS) | |
| John McKee | Communications and Engagement Manager | |
| Rachael Fletcher | Communications and Engagement Officer |
thnic Communities
(April 2018)Ethnic-Communities-Edinburgh-April-2018.pdf
| Evidence | Available – detail source | Comments: what does the evidence tell you with regard to different groups who may be affected and to the environmental impacts of your proposal |
|---|---|---|
| Data on populations in need | Joint Strategic needs Assessment City of Edinburgh HSCP (2020)
Edinburgh HSCP Edinburgh Integration Joint Board Strategic Plan (2019-2022) |
Provides current and projected data on the wider population in the City of Edinburgh (Population and demographics – Edinburgh Health & Social Care Partnership (edinburghhsc.scot)
Provides an understanding of what contributes to poor health and wellbeing and the barriers and challenges to seeking and obtaining support (many being interrelated). Actions highlighted as needed to address these include:
Details the Strategic direction of the EHSCP https://www.edinburghhsc.scot/wp-content/uploads/2020/01/Strategic-Plan-2019-2022-1.pdf |
| Data on service uptake/access | Service uptake/access reports
Adults with Incapacity Act Mental Health Act Monitoring Report 2023-24 EIJB Performance annual reports Performance report for Whole System Delivery Oversight Group |
The performance and evaluation team have access to various data sets on service uptake/access.
The Mental Welfare Commission for Scotland (the Commission) has safeguarding duties in relation to people who are subject to the protection of the Adults with Incapacity (Scotland) Act 2000 (the AWI Act) [1]. This duty includes monitoring the use of welfare guardianship orders for adults with a mental illness, learning disability, dementia, and related conditions, to determine how and for whom the AWI Act is being used. This helps us to inform policy and practice. The Mental Welfare Commission (the Commission) has a duty under section 5 of the Mental Health Act to monitor and promote best practice in the use of the Act. This report is published as part of this duty and outlines data primarily on the use of the Mental Health Act during 2023-24. This performance report sets out our progress against the strategic priorities within The performance and evaluation team produced this report for the Whole System Delivery Oversight Group. HSC surveys and service users reports National waiting times targets and standards |
| Data on socio-economic disadvantage e.g. low income, low wealth, material deprivation, area deprivation. | Joint Strategic Needs Assessment City of Edinburgh HSCP (2020)
Director Public Health annual report Edinburgh Poverty Commission |
Provides current and projected data on the demographics within Edinburgh (Population and demographics – Edinburgh Health & Social Care Partnership (edinburghhsc.scot)
Provides details on the experience of poverty in Edinburgh |
| Data on equality outcomes | Scottish Government – Scottish Health Survey
Locality profiles Census data |
https://www.gov.scot/collections/scottish-health-survey/
Our Localities profile tool gives you facts and statistics about smaller areas within Edinburgh. It covers all 17 wards, the 4 localities, Edinburgh and Scotland and allows you to do a side-by-side comparison on subjects such as:
https://www.edinburgh.gov.uk/downloads/download/13733/localities-profile-search-tool |
| Research/literature evidence | Care Inspectorate SW SC Inspection Report
SWSC IP plan Follow up inspection Audit Scotland –IJBs report |
Edinburgh was inspected in relation to adult social work and social care in Edinburgh – City of Edinburgh inspection report March 2023.pdf (careinspectorate.com)
Joint Inspection of Adult Support and Protection Review of progress in the Edinburgh City Partnership Area – ASP RP_EdinburghCity_final 191124.pdf Audit Scotland report on community health and social care facing rising unmet need and managing the crisis is taking priority over prevention due to the multiple pressures facing the bodies providing these services. |
| Public/patient/client experience information | Scottish Government – Scottish Health Survey | https://www.gov.scot/collections/scottish-health-survey/
HSC surveys and service users reports |
| Evidence of inclusive engagement of people who use the service and involvement findings | N/a | |
| Evidence of unmet need | Unmet Need Data | The performance and evaluation team have access to the unmet need list of those awaiting assessments & packages of care and delayed discharges, access to MH, LD and SU services. |
| Good practice guidelines | Legislation governing the provision of EHSCP services | The following legislation is relevant to the provision of such support:
Social Work (Scotland) Act 1968 National policies and frameworks: National Health & Social Care Standards The Community Care (Personal Care and Nursing Care) (Scotland) Amendment Regulations 2021 – The Community Care (Personal Care and Nursing Care) (Scotland) Amendment Regulations 2021 (legislation.gov.uk) Local policies: ASP Policy |
| Carbon emissions generated/reduced data | N/a | |
| Environmental data | N/a | |
| Risk from cumulative impacts | 24/25 Savings Programme IIA report | Sets out the cumulative impacts of the existing in-year savings & recovery programme. https://www.edinburghhsc.scot/wp-content/uploads/2024/03/0.-Savings-programme-24-25-Cumulative-IIA.pdf |
| Other (please specify) | Local workforce data
LEZ |
The EIJB Workforce strategy provides information on partnership workforce numbers and profile, use of HSC services, projected demand and sets out workforce priorities.
Web pages on EHSCP Workforce NHS and Council staffing data MTFS – Medium Term Financial Strategy Carbon emissions generated/reduced data – City Vision 2050 consultation – Policy and Sustainability Committee agreed a ‘Short Window Improvement Plan’ (SWIP) in October 2019 |
| Additional evidence required | N/a |
w Low Emissions Zone potential for increased cost and or mileage if colleagues use their own transport to travel across the city.
| Equality, Health and Wellbeing and Human Rights | Affected populations |
|---|---|
| Positive The aim of the restructure is to provide more stability, improve stress level and wellbeing of staff by reducing the number of interim posts. There will be clearer lines of accountability and role definitions. Job Descriptions will be reflective of roles and ensure accountability and improved governance, there will be clear lines of management including professional. Assessment and Care Management, Mental Health Officer (MHO) and Mental Health, Learning Disabilities and Substance Use services will be standardised and this should be more positive and less restrictive experience for people. The proposal is to also reduce variance across services and localities and improve links across services. The change in MHO will provide permanence and stability as management at this level has been on a temporary/fixed term basis for some time now. This restructure aims to impact positively on people as they will be able to access the right service at the right time, changes should lead to reduced waiting times, improved communications and flexibility of staff to move across the city. Process between Social Care Direct and localities will be streamlined. The aim is to provide more opportunities for holistic care and person centered care. The proposed restructure aims to strengthen the governance arrangement for transition services which should improve outcomes for people transitioning from children to adults. Improving professional governance can strengthen quality and safe care. Locality working will be retained in these proposals. |
EHSCP employees
Edinburgh citizens |
| Negative Policies of both organisations provide a level of protection but it is causing uncertainty and stress amongst staff and colleagues who are directly and indirectly impacted. Change is difficult for people and we aim to reduce this through providing clear and timely communications, line manager support and signposting to appropriate supports, e.g., the Council’s EAP provider PAM Assist. With the introduction of the new Low Emissions Zone potential for increased cost and or mileage if colleagues use their own transport to travel across the city. Issue with Council transport vehicles not being compliant with LEZ. |
EHSCP employees
Edinburgh citizens |
| Environment and Sustainability including climate change emissions and impacts | Affected populations |
|---|---|
| While the restructure might provide opportunity for consideration of existing buildings/resources these are not going to be directly impacted at this stage. |
| Economic | Affected populations |
|---|---|
| Positive Access to services will be improved by effective operational management. Job Descriptions will be developed to ensure staff are paid appropriately for their work. Working conditions and stability of services will improve by reduced interim posts. Improved opportunities for career progression. Potential for decisions should be made more effectively by strengthening operational management for example purchasing budget decisions. |
EHSCP employees |
| Negative Vacancies to fund these posts might have to be deleted. |
EHSCP finances |
A detailed comms plan has been developed for the Restructure with set timescales, methods of communication and list of who needs to be engaged.
If yes, it is likely that a Strategic Environmental Assessment (SEA) will be required and the impacts identified in the IIA should be included in this. See section 2.10 in the Guidance for further information.
No
| Specific actions (as a result of the IIA which may include financial implications, mitigating actions and risks of cumulative impacts) | Who will take them forward (name and job title) | Deadline for progressing | Review date |
|---|---|---|---|
| Continue to ensure that the NHS and Council policies are followed. Continue to work closely together across the Council and NHS. | EHSCP Restructure Project team. | Throughout the process. | |
| Continue to strengthen professional leadership including collaboration with managers. | It is proposed that this will be done by the Professional leads, HoS and Service Managers. | Once the proposed posts are filled, the whole team in the service area will work together to strengthen professional governance. |
This will be monitored throughout the consultation process, normal management channels and through regular engagement with the Trade Unions. We will also carry out a post review feedback exercise to ensure we identify any lessons learned.
Name: Tony Duncan, Head of Strategic Planning
Date: 3 September 20201