Integrated Impact Assessment statements
Under option 2 of SDS legislation, a person can choose to have their support provided through an Individual Service Fund (ISF), where an individual budget is paid directly to a chosen provider, who works with the person to agree their support provision. Routine underspends occur in ISF accounts. These underspends happen for a variety of reasons, such as hospital admissions. The ISF Provider is contractually obliged to return any unspent money that has not been required to deliver care and support either during hospital admission or post-discharge.
A full IIA is therefore not required for this proposal as the reclaim is undertaken under business-as-usual contract management and monitoring processes. There will be no impact on individual service users.
Moira Pringle
Chief Finance Officer
16 January 2025
In 2024/25, a savings proposal aiming to renegotiate the placement rate with care home providers to the current NCHC, or as close to this rate as possible, in line with Council policy, was approved by the EIJB as part of its Savings and Recovery Programme. Due to resourcing and capacity issues, this work was delayed and will now take place within 2025/26.
Impacts were assessed in February 2024 and the Integrated Impact Assessment can be found on the EHSCP website. This identified that direct impact on service users would only occur if the negotiations resulted in a move to alternative provision. At present, no moves are anticipated and therefore it has not been deemed necessary to carry out an Integrated Impact Assessment at this time. If this should change, a full IIA will be completed to ensure any impacts are captured.
Mike Massaro-Mallinson
Service Director – Operations
16 January 2025
Each Autumn, the NHS Lothian Pharmacy Dept co-ordinates a process to identify proposals to deliver common efficiencies in the primary care prescribing budget across all the Partnerships. The 25/26 NHS Lothian Primary Care Prescribing Plan builds on existing and established prescribing initiatives which promote cost effective prescribing without compromising patient care. The plan has been developed by the pharmacy team with extensive stakeholder engagement. The aim of the scheme is to promote financial stability through implementation of a range of prescribing projects led by pharmacy with the involvement of all appropriate teams.
The 25/26 Prescribing Plan will be considered for approval by the Lothian prescribing Forum in March 2025. A combined Integrated Impact Assessment has been scheduled for 24th April 2025 and will be published in due course.
SRO: Mike Massaro-Mallinson, Service Director for Operations
16 January 2025
This saving proposal relates to 2c practices, which are GP practices which have been brought in-house and are managed by the EHSCP. There are currently 8 2c practices in Edinburgh, which is an unusually high number, increasing budget pressures in Primary Care. Grip and control measures around staffing were implemented in 2024/25 to partially relieve the budget strain.
In 25/26, we are proposing to transfer 2c practices back into private provision. It is anticipated that up to 4 practices will be transferred in this financial year. IIAs will be completed as part of the tendering process for each practice and it is therefore not appropriate to complete a full IIA at this time. The IIAs which are completed will be approved by the relevant Head of Service in due course.
SRO: Mike Massaro-Mallinson, Service Director for Operations
16 January 2025
Hosted services are operationally managed by a HSCP or business unit within NHS Lothian on behalf of two or more of the Lothian IJBs. For example:
- Dietetics is a single system team that is managed within Midlothian HSCP on behalf of all four Lothian IJBs; and
- Inpatient adult mental health is hosted within the Royal Edinburgh and Associated Services (REAS) business unit on behalf of East Lothian, Edinburgh and Midlothian.
Similarly set aside services are acute, hospital based and are operationally managed by NHS Lothian on behalf of all 4 IJBs.
Operational business units within NHS Lothian are expected to break even and demonstrate 3% efficiency savings on a yearly basis. Each business unit will develop savings plans locally and some of these will involve services hosted on behalf of IJBs. The development, implementation and monitoring of these schemes and any associated impacts will take place in accordance with local governance arrangements.
Moira Pringle
Chief Finance Officer
16 January 2025
The Primary Care Vaccination Fund was originally provided by the Scottish Government as result of the pandemic on a non-recurring basis. Edinburgh’s share in 2024-25 was c£4.4m. The vaccination transformation programme is overseen by NHSL Vaccination Delivery Board and delivered by the four Health and Social Care Partnerships. The programme delivers all types of vaccinations including flu, COVID19, pneumococcal, shingles etc.
Since the pandemic, uptake of vaccinations in the city has dropped to pre-pandemic levels (uptake of the Winter Vaccination Programme has reduced from 66% in 2022/23 to 54% in 2023/24). It is therefore proposed to redesign the service in line with these reduced uptake figures by revising the additional staffing capacity which is currently provided via the staff bank.
As it is anticipated that the saving can be delivered through supplementary staffing reductions and underspend, it is not anticipated that there will be impacts on service delivery or outcomes for people. As such, a full Integrated Impact Assessment is not deemed to be necessary. Should the savings not be possible through this route and any reduction in the number of vaccination sites be necessary, then a full IIA would be conducted prior to proceeding.
Mike Massaro-Maillinson
Service Director for Operations
16 January 2025
The EHSCP spends approximately £30m on a wide range of block contracts for externally commissioned services and supports. Block contracts provide a range of different services including: day opportunities, advocacy support, overnight support, carers contracts, Thrive mental health services, information and advice services, adult community treatment services, specialist condition specific supports and volunteer support.
Many of these contracts have been in place for some years, having been originally commissioned to meet priorities at the time. Given the size and scale of the financial challenge, the Service Director for Strategy intends to review and evaluate all block contracts to ensure that they remain:
- Aligned to current strategic priorities and the refreshed IJB Strategic Plan
- Focused clearly on the provision of delegated services which meet our statutory duties
- Delivering the volume and outcomes anticipated
Until the contract review is complete, it is not possible to determine exactly which contracts would be reduced or ceased. Full Integrated Impact Assessments are therefore not possible at this time, but will be undertaken and shared with the IJB once the review is complete.
Andrew Hall
Service Director for Strategy16 January 2025
Within the EHSCP, options are currently being considered for structural reorganisation across the Operations division. Any organisational review will always strictly adhere to the agreed change policies within both NHS Lothian and the City of Edinburgh Council.
The Telecare and Social Housing review is included as part of this process. Therefore, a full IIA for Telecare and Social Housing Savings will be completed at an appropriate point in this organisational process and will be made available as part of the consultation information pack.
Structural change and reorganisation is a normal part of our business, delegated to the Chief Officer and the Executive Management Team to complete. Whilst organisational review within 25/26 is planned and anticipated to release financial efficiencies, engagement with staff is still underway and options are still being developed. It is therefore not appropriate to complete an IIA at this time. The IIA will be completed and approved by the relevant Head of Service in due course.
Mike Massaro-Mallinson
Service Director – Operations
16 January 2025
The Edinburgh Carers Strategy 2023-26 sets out the vision, priorities and outcomes for health and social care planning partners to make Edinburgh a caring city.
- A city where carers have rights, choices, and opportunities to access a wide range of supports.
- A city where carers have a voice, individually and collectively.
- A city which respects carers as equal partners in care and where carers feel valued and well supported in their communities.
- A city where carers care with confidence and in good health
On an annual basis, a spend programme is developed to support the delivery of the Carers Strategy. In recent years however, it has been recognised that the EHSCP purchasing budget increasingly bears significant additional costs for replacement care outwith this programme, which directly benefits unpaid carers. For 2025/26, there is currently £1.5m of unallocated carers funding within the programme. This proposal recommends that this funding is transferred to the purchasing budget to offset the additional costs incurred.
While this proposal represents an opportunity loss due to the funding not being made available to support new initiatives, it is not possible to assess the impact of this as no specific plans had been made for this funding. As such, it is deemed that a full IIA is not possible.
Andrew Hall
Service Director for Strategy
16 January 2025