Integrated Impact Assessment – Gross funding reclaim management - Edinburgh Health & Social Care Partnership

Integrated Impact Assessment – Gross funding reclaim management

1. Title of plan, policy or strategy being assessed

Gross funding reclaim management

2. What will change as a result of this proposal?

Additional MHO capacity has been recruited to streamline the financial guardianship element of the Gross Funding process, which will ensure existing placements more efficiently managed to conclusion.

In Addition, process and guidance will be developed to reduce the number of new Gross Funding placements being agreed.

3. Briefly describe public involvement in this proposal to date and planned

None.

4. Is the proposal considered strategic under the Fairer Scotland Duty?

5. Date of IIA

7 February 2025.

6. Who was present at the IIA?

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
Sarah Hayden	Business Manager	9^th March 2022 Facilitator & Report Writer
Catherine Mathieson	Cluster Manager – South East	EHSCP employee
Kerry Garvin	Senior Transactions Officer	CEC employee
Lorraine McFarlane	Team Leader – Transactions	CEC employee
Julie Rough	Senior Social Worker, Residential Review Team	EHSCP employee
Thamalee Peiris	Senior Social Worker, Residential Review Team	EHSCP employee
Pauline Walker	Project Implementation Manager, Contracts Team	EHSCP employee
David MacLullich	Interim Team Manager, MHO Service	EHSCP employee

7. Evidence available at the time of the IIA

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

Joint Strategic Needs Assessment:

Health and Care Needs of People from Minority Ethnic Communities

(April 2018)

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:

Staff training including cultural sensitivity
Recognition of the role of the Third Sector
Effective community engagement
Developing effective approaches to prevention including overcoming isolation.

https://www.edinburghhsc.scot/wp-content/uploads/2020/03/JSNA-Health-Needs-of-Minority-Ethnic-Communities-Edinburgh-April-2018.pdf

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

Gross Funded people

Data held internally, summary below:

105 care home residents being gross funded for their placement until access to their capital and income can be established.

Of these, 51 require financial guardianships to progress.

Historic data on number of Gross Funding cases concluded per year:

	#cases	#days delayed
2012	1	14
2013	1	48
2014	1	166
2015	3	365
2016	5	1133
2017	6	748
2018	12	2500
2018	1	337
2019	19	4016
2019	2	1468
2020	22	7486
2020	2	1814
2021	49	18376
2021	14	6859
2022	19	10778
2022	50	22954
2023	10	6968
2024	25
TOTAL	242	86030
NB: Some of the years are included twice because some were on the legacy list
and some were logged and finalised on separate sheets

Data on socio-economic disadvantage e.g. low income, low wealth, material deprivation, area deprivation.

Joint Strategic needs Assessment City of Edinburgh HSCP (2020)

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

(Population and demographics – Edinburgh Health & Social Care Partnership (edinburghhsc.scot)

Data on equality outcomes

Data not available.

Research/literature evidence

Adults with Incapacity Act monitoring report 2023-24

https://www.mwcscot.org.uk/sites/default/files/2024-09/AWI%20Monitoring%20Report%202023-24.pdf

Public/patient/client experience information

Evidence of inclusive engagement of people who use the service and involvement findings

Evidence of unmet need

Not applicable

Good practice guidelines

Code of practice for Financial Guardians

AWI Codes of Practice for Local Authorities

https://www.gov.scot/publications/adults-incapacity-scotland-act-2000-code-practice-persons-authorised-under-intervention-orders-guardians/pages/6/

https://www.publicguardian-scotland.gov.uk/docs/ librariesprovider3/ guardianship/pdf-documents/ generalguidancenotesforfinancialguardians.pdf?sfvrsn=877d01d3_2

https://www.gov.scot/publications/adults-incapacity-scotland-act-2000-code-practice-local-authorities-exercising-functions-under-2000-act/documents

Carbon emissions generated/reduced data

Not applicable

Environmental data

Not applicable

Risk from cumulative impacts

Not applicable

Other (please specify)

Not applicable

Additional evidence required

8. In summary, what impacts were identified and which groups will they affect?

Equality, Health and Wellbeing and Human Rights	Affected populations
Positive It would help to prevent/reduce people waiting for financial guardianship to be in place. By speeding up the financial guardianship process, it would enable quicker access for people to their own capital, income and benefits Increasing capacity in the MHO service has reduced the pressure within the team. Increased fairness due to financial guardianship processes being managed in a consistent and timely way. Improves equality of access to people in receipt of gross funding having dedicated MHO availability. Will enable people to have greater control of their social environment due to affected people being involved in decision making. Could reduce differences in status between people by ensuring people are able to access their funds and benefits sooner. Improved participation, inclusion, dignity and control over decisions due to improved access to MHO service. Will protect vulnerable adults by ensuring people are able to access their funds and benefits sooner.	Potentially all populations, but the group most affected by this proposal is older people. All populations FT, PT and Casual staff All populations
Negative With dedicated capacity from the MHO service, this may have an impact on other service areas.

Equality, Health and Wellbeing and Human Rights

Affected populations

Positive

It would help to prevent/reduce people waiting for financial guardianship to be in place.
By speeding up the financial guardianship process, it would enable quicker access for people to their own capital, income and benefits
Increasing capacity in the MHO service has reduced the pressure within the team.
Increased fairness due to financial guardianship processes being managed in a consistent and timely way.
Improves equality of access to people in receipt of gross funding having dedicated MHO availability.
Will enable people to have greater control of their social environment due to affected people being involved in decision making.
Could reduce differences in status between people by ensuring people are able to access their funds and benefits sooner.
Improved participation, inclusion, dignity and control over decisions due to improved access to MHO service.
Will protect vulnerable adults by ensuring people are able to access their funds and benefits sooner.

Potentially all populations, but the group most affected by this proposal is older people.
All populations
FT, PT and Casual staff
All populations

Negative

With dedicated capacity from the MHO service, this may have an impact on other service areas.

Environment and Sustainability including climate change emissions and impacts	Affected populations
Positive No impact
Negative No impact

Environment and Sustainability including climate change emissions and impacts

Affected populations

Positive

No impact

Negative

No impact

Economic	Affected populations
Positive Improved access to services by ensuring people are able to access their funds and benefits sooner. Smaller care homes may benefit from people being able to access their funds sooner. Reduce income inequality due to people being able to access their funds sooner. Provides more effective use of HSCP resources as purchasing budget is temporarily covering costs of care home fees that will be covered by the income and capital of individuals.	All populations
Negative No impact

Economic

Affected populations

Positive

Improved access to services by ensuring people are able to access their funds and benefits sooner.
Smaller care homes may benefit from people being able to access their funds sooner.
Reduce income inequality due to people being able to access their funds sooner.
Provides more effective use of HSCP resources as purchasing budget is temporarily covering costs of care home fees that will be covered by the income and capital of individuals.

All populations

Negative

No impact

9. Is any part of this policy/ service to be carried out wholly or partly by contractors and how will equality, human rights including children’s rights , environmental and sustainability issues be addressed?

Not applicable

10. Consider how you will communicate information about this policy/ service change to children and young people and those affected by hearing loss, speech impairment, low level literacy or numeracy, learning difficulties or English as a second language? Please provide a summary of the communications plan.

If approved, the increased capacity will be communicated to the MHO Service Manager in the first instance. Wider communication will be shared with localities making them aware of the changes.

11. Is the plan, programme, strategy or policy likely to result in significant environmental effects, either positive or negative?

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.

12. Additional information and evidence required

Information and further evidence has been requested from the attendees of the IIA and the Performance and Evaluation Manager, as per the above table.

13. Specific to this IIA only, what recommended actions have been, or will be, undertaken and by when? (these should be drawn from 7 – 11 above)

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

Edinburgh Integration
Joint Board