Savings programme 2024-25 – Early intervention and prevention integrated impact assessment

IIA to assess impact of proposal to reduce funding within the prevention and early intervention workstream.

Wider discussion on funding reduction to 3rd sector including :

  • Organisations who are funded as part of the Inequalities Grants
  • Organisations who are funded as part of Community Mobilisation
  • Edinburgh Community Health Forum – voluntary sector discussions
  • EVOC engagement
  • IIA meeting

29 February 2024

Name Job Title Date of IIA training
Rhiannon Virgo Project Manager – Innovation and Sustainability February 2020
Dr Linda Irvine Fitzpatrick Strategic Programme Manager, Thrive Edinburgh and  Substance Use

SRO, Edinburgh Wellbeing Pact, Community Mobilisation, Prevention and Early Intervention

Cat Young Assistant Programme Manager (Thrive) November 2018
Emma Gall Assistant Programme Manager (Thrive)
Ian Brooke Deputy Chief Executive EVOC
Stephanie-Anne Harris Strategic Development Manager

Edinburgh Community Health Forum

Suzanne Lowden Strategic Planning and Commissioning Officer
Susan Robertson Strategic Planning and Commissioning Officer for Physical Disabilities
Anna Wimbley Programme Manager – Long Term Conditions
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 Population and demographics – Edinburgh Health & Social Care Partnership (edinburghhsc.scot)

Household data

Census 2022

thetriangleofcare-thirdedition.pdf (nhslothian.scot)

Provides current and projected data on the wider population in the City of Edinburgh

How we should be working with carers

Carers Survey forthcoming

Data on service uptake/access National Benchmarking data

https://www.edinburghhsc.scot/moregooddays/

NESSie – NESSie – Fresh Start (freshstartweb.org.uk)

2021/22 LGBF data shows an increase in the number of people supported to live as independently as possible.

Report on Community Mobilisation, Accelerate and Capacity to Collaborate  programmes

Data on socio-economic disadvantage e.g. low income, low wealth, material deprivation, area deprivation. Joint Strategic needs Assessment City of Edinburgh HSCP (2020)

https://www.edinburghhsc.scot/the-ijb/jsna/

Tackling Inequalities to reduce mental health problems – Mental Health Foundation (Jan 2020)

Edinburgh poverty commission report – A just capital: Actions to end poverty in Edinburgh

Provides current and projected data on the demographics within Edinburgh

Disproportionate  impact of CVovid 19 for people with protected characteristics and people experiencing mental ill health and illness

Actions to end poverty – commitment to end poverty in the city by 2030

Key publications focusing on food poverty and strategies to address this

Data on equality outcomes JSNA-Health-Needs-of-Minority-Ethnic-Communities-Edinburgh-April-2018.pdf (edinburghhsc.scot) Provides data on demographics of minority ethnic communities
Research/literature evidence Hard Edges Report  -Scotland Health impact on woken experiencing disadvantages
Public/patient/client experience information https://www.edinburghhsc.scot/moregooddays/ Evidence reports from Capacity to Collaborate projects

Evidence of unmet needs through Community Mental health Fund research

Evidence of inclusive engagement of people who use the service and involvement findings Complaints/ compliments Each organisation receiving grants will have examples of case studies included in annual reports
Evidence of unmet need Edinburgh Integration Joint Board Strategic Plan (2019-2022) Details the health needs and priorities for the people of Edinburgh

Strategic-Plan-2019-2022-1.pdf (edinburghhsc.scot)

Good practice guidelines https://www.gov.scot/publications/national-good-food-nation-plan/pages/4/ National Good Food Nation Act – which places duties on ministers, local authorities and health boards- as part of the Scottish Food Coalition organisations supported by EIJB  are playing a vital role  in ensuring Edinburgh’s ability to deliver the Act’s mandatory duties.
Carbon emissions generated/reduced data N/A
Environmental data N/A
Risk from cumulative impacts
Other (please specify)
Additional evidence required

If you would like to view any of the documents noted in the table, email linda.irvinefitzpatrick@nhslothian.scot.nhs.uk 

Equality, Health and Wellbeing and Human Rights

 

Affected populations
Positive

 

 
Negative

 

Health Inequalities Grants –  Approximately 51,321 people (see Appendix One)  took part in activities/used services funded through the EIJB grant programme  and will be impacted on across all communities and demographics with a risk to:.

·       People’s physical and mental health which in turn will impact on statutory services.

·       Further demand for referrals and assessments

·       Potential impact on social care direct

·       May increase poverty.

·       Increase in social isolation and loneliness.

May impact young people going through transition who may feel lack of support

Will impact vulnerable older people in community – social isolation, poor mental health and wellbeing.

Will impact young people and children from vulnerable families, looked after children, and young adults going through transition.

Women may be impacted more due to carer roles within families.

Disabled people will feel deeper specific impact – lack of support and opportunities. Friendships and activities.

Potential impact on ethnic minority organisations providing support – IIA in 2018 already noted lack of ethnic minority so further impact. May impact:

The Welcoming, Feniks, Sahelyia, MECOPP

Will adversely affect people living with isolation.

Will reduce opportunity for people to connect with their natural communities.

Transitions are extremely essential and vulnerable points in life and the support has to be there to help ensure these are meaningful and fulfilling experiences. As above.

Lack of opportunities for unemployed people to get volunteer opportunities or more competition in job market.

Will increase number of people on benefits potentially.

Will specifically impact vulnerable families who current seek and require support from organisations.

With evidence from community resilience team showing people leaving care settings need ‘basic needs’ helped with, such food and heating – can impact on delayed discharge from hospitals.

Carers benefit from periods of respite when their cared for, and themselves can access a range of opportunities. If these are ceased, their caring role becomes more demanding and their own MH and wellbeing is affected. This can lead to a crisis point when more social care input is required.

Communications:

Effective, inclusive and accessible information and communications are required could mitigate the sense of isolation and exclusion, and possibly encourage collective peer support and community of interest cohesion.

May impact on communities out with city centre area – more rural if organisations get reduced finance which causes closures – further understand of where may be impacted.

General:

·       people will feel more isolated with lack of community connection and support.

·       lack of opportunity to engage and participate.

·       staff and volunteers may feel insecure about work environment.

·       will increase divide between people with money and less.

·       will reduce opportunities to build community and participate.

·       Opportunities to get activity, be part of something that promotes learning, health, and wellbeing,

Multi layered impact on staff:

·       Will impact staff both paid and in volunteering roles – people may fall into poverty or increased mental health.

·       Will impact staff’s ability to find appropriate support or places to signpost to.

·       Fewer opportunities for volunteering

·       Confidence and competence are crucial factors for staff. Support and promoting positive regard are essential to reassure

Food Poverty is a major commitment for the City of Edinburgh and is one of the work streams within the Edinburgh Poverty commission. It is an integral part of Poverty commission work  to which the EIJB is signed up.

·       Food insecurity levels – these are not available at Edinburgh level:

·       The 2021 Scottish Health Survey showed that 9% of adults experienced food insecurity in the preceding 12 months, defined as worrying about running out of food due to lack of money or other resources.

·       At UK level, the latest data on food insecurity comes from JRF’s UK Poverty 2024 – “The prevalence of food insecurity varies between different groups of people in poverty. In 2021/22, more than one in five children in poverty (22%) experienced insecurity, compared with 18% of working-age adults. But both children and adults were equally likely to experience very low food security (9%). Meanwhile only 3% of pensioners in poverty were food insecure

 

Older people and people in their middle years

Young people and children

Men (include trans men), Women (include trans women) and non-binary people. (Include issues relating to pregnancy and maternity including same sex parents)

Disabled people (includes physical disability, learning disability, sensory loss, long-term medical conditions, mental health problems)

Minority ethnic people (includes Gypsy/Travellers, migrant workers, non-English speakers)

Refugees and asylum seekers

People with different religions or beliefs (includes people with no religion or belief)

Lesbian, gay, bisexual and heterosexual people

Unemployed

People in receipt of benefits

Lone parents

Vulnerable families eg young mothers, people experiencing domestic abuse, children at risk of statutory measures, includes disabled adult/child, minority ethnic families

People in receipt of pensions

Care experienced children and young people

Carers (including young carers and carers with protected characteristics)

 

 

 

 

 

 

Geographical

Staff in statutory and 3 3rd sector

People living in poverty / experiencing  food poverty

 

Environment and Sustainability including climate change emissions and impacts

 

Affected populations
Positive

 

 
Negative

Reduction in local provision resulting in people having to travel more

 

All

Economic

 

Affected populations
Positive

 

 
Negative

 

·       Due to cuts people may need to go on benefits for financial support.

·       Could increase poverty.

·       May see closure of buildings.

·       Lack of jobs and volunteering/training opportunities

·       Increased impact on services and supports including GPs and hospital services

 

 

 

 

 

 

 

All

The Edinburgh Health and Social Care Partnership commissions services from both the third and independent sector.  Robust contract management arrangements ensure that this will be addressed.

 

We have a commissioned Human Rights Training Programme which we can utilise to further understand impact.

Communications and Engagement Team to advise on this along with taking advice and expertise from those working with groups on most appropriate and effective ways to communicate.

We will also utilise different approaches including film, photo, voice and podcasts.

If further evidence is required, please note how it will be gathered.  If appropriate, mark this report as interim and submit updated final report once further evidence has been gathered.

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
EHSCP should work with partners to gain clarity  and promotes

what is available for our unique populations

Linda Irvine Fitzpatrick,

Strategic Programme Manager

Commence April 2024 – ongoing March 2024
EHSCP should meet with partners affected by the savings to discuss the impact and plan together for going forward Linda Irvine Fitzpatrick , Strategic Programme Manager Commence late March 2024 August 2024
EHSCP should work with colleagues and experts to ensure communications are made available for all especially those with sensory loss John McKee, Comms and Engagement Manager Commence late March 2024 August 2024
A shared impact of the savings should be circulated for transparency and learning Pat Togher May August 2024
Work with Volunteer Edinburgh to promote volunteering opportunities in the community Linda Irvine Fitzpatrick Strategic Programme Manager, Commence May 2024 August 2024
Continue, and strengthen, the approach already being taken by the EHSCP contracts team to monitor impacts across providers and allow for early warning where a specific provider may be at risk through reductions. Emma Gunter Ongoing throughout 2024/25 August 2024
Work closely with other partners to identify alternative funding sources (such as the Big Lottery) to offset any loss of funding. It was recognised however, that such funds are under increased pressure nationally. Linda Irvine-Fitzpatrick Ongoing throughout 2024/25 June 24
Work closely with third sector partners to prioritise and innovate to spend the remaining funding in the most effective way. It was recognised that there was opportunity to consolidate community bases to focus on areas of deprivation and thereby contribute more to the local economy in these areas. Linda Irvine-Fitzpatrick Ongoing throughout 2024/25 June 24
Continue to develop plans to redesign the front door in an integrated way, with third sector at the heart of this as an opportunity to build on early intervention and prevention. Pat Togher March 2025 June 24
Ensure that community benefits from any commercial procurement contracts are fully realised to help mitigate any reduced funding. Emma Gunter/ Moira Pringle March 2025 June 24
Work with partners to develop a poverty strategy for the EIJB and ensure that all partners are aware of income maximisation approaches and opportunities. Pat Togher March 2025 June 24

The actions outlined above will mitigate the majority of negative impacts to some extent, but the size and scale of the financial challenge means that it will not be possible to remove them entirely.

  • More localities provider meetings to improve communication and allow for faster interventions and enrich our understanding
  • Coproduction of future provision involved by communities of interest, identity and locale

Name: Mike Massaro-Mallinson

Date: 11/03/2024