My November diary

It’s been an action-packed month this November. We held our first Welcome Event for new-starts this month. We chose the new East Lothian Community Hospital as our venue, using the new Community Hall.  It’s fantastic to see the hospital signed off and fully functional.  Thanks to John Gibson and Barbara Renton for organising a very successful event and thanks to the ELCH Project Team and all the staff at ELCH for getting everything at the hospital up and running so smoothly.

It is the awards season and I have been out and about at various events, including The Queens Nursing Institute of Scotland and East Lothian Council’s Star Awards in which we did very well – see my post about Celebrating Success.

It’s been really busy getting ready for winter. The IJB signed off our winter plan at its October meeting and we can see pressures building up in our A&E departments. I would welcome any help you can give me in persuading people to use other more appropriate services like NHS24 and NHSInform if they can. The message from our A&Es is ‘use our services wisely’. Please help us get the message out there if you can. Find out more about our Winter Plan.

We had a really useful management engagement event at the end of November, at which we caught up with what a range of teams were achieving through partnership and integrated working and innovative approaches. A full write up will follow soon.

I was at the Heath and Social Care Scotland Conference at which Jeanne Freeman, Cabinet Secretary for Health was a keynote speaker, and attended the Lothian IJB Chief Officers’ Group, and, of course, there was the regular meeting with the IJB Strategic Planning Group.

Like lots of you, I expect, I am looking forward to the festive season but would like to express my real appreciation to those of you who will be leaving your friends and families over the festive period to look after our frail and vulnerable patients and clients.

Welcome event 26 November 2019

We held our first ELHSCP welcome event for new starts with the Partnership (and some not so new!)

As part of the session, we asked people five key questions – see what they said.

What would you like to hear people saying about East Lothian HSCP?

• They take notice of complaints
• They are delivering relevant services
• Value for money
• Consistency of care/carers
• Provide effective and efficient services
• Modern, up-to-date, fit for purpose
• They care for you
• That we are addressing pubic concerns like those described by Marilyn
• Improving community services
• Learning from best practice elsewhere – networking and making sure we have the resources and time to do so
• Individualised and focused
• It’s a great place to work
• That we are dynamic and proactive
• Right place, right time, right solutions, right approach
• Forward thinking
• That we listen and learn
• Respecting of others
• Know about the partnership and what it’s responsible for

What’s been the best thing so far about working in East Lothian?

  • Location
  • Community
  • Variety
  • Organised
  • Effective leadership and valued
  • Opportunity to develop
  • Transport
  • The people
  • Being appreciated
  • Proactive environment
  • Geographically mixed, e.g., towns and country
  • No traffic
  • Meeting new people
  • Views taken into account
  • Consulted!
  • Having good relationships with other staff

How do you want to treat each other?

  • With respect
  • Recognising skills
  • As EQUALS
  • Utilising/recognising skill mix and using them
  • Supporting people
  • Kindness and interest
  • Approachability
  • Understanding colleagues caring needs
  • ‘no blame’ culture – accept that people make mistakes
  • Looking at what skills people have outside the workplace
  • Recognising time constraints
  • Fairness and consistency
  • Good communication
  • Valued
  • As a team.

What questions would you put to senior managers present today?

  • What opportunities are there for development and progression?
  • What procedure/framework is there for reporting issues?
  • Do you like your job?
  • Are there opportunities to shadow you in your role?
  • Is there a support framework for staff who would like to develop skills to move out of their professional ‘box’ into something different?
  • Is there any support for staff dealing with difficult issues?
  • How do you cope/deal with all the stress/complaints you deal with on a daily basis?
  • If staff have an important idea for development, where should they discuss this?

What matters to you when you are at work?

  • Team working
  • Person-centred care
  • Break time
  • Collaborative leadership
  • Recognition
  • IT working OK
  • Being valued
  • Good staff relationships
  • Hot-desking limits a feeling of belonging
  • Good support system
  • Nice working environment.

This is all valuable feedback and will be taken account of. More ideas – keep them coming to myvoice@eastlothian.gov.uk

  1. Gorgeous. Well done guys, another really lovely inclusive project within the community.

Community Justice Self-Evaluation Review

Welcome to the first update from the Self Evaluation Leads Team working on the Self Evaluation & Validation process facilitated by the Care Inspectorate

The vision of Community Justice Scotland is that ‘Scotland is a safer, fairer and more inclusive nation’ where we:

Prevent and reduce further offending by addressing its underlying causes
Safely and effectively manage and support those who have committed offences to help them reintegrate into the community and realise their potential for the benefit of all citizens

The purpose of the Self-evaluation and Validation process is to build capacity among community justice partnerships to quality assure their own. We will work together and use the insights gained to plan and implement improvements. The improvements found in this process will be included in the 2020 Local Outcome Improvement Plan for East Lothian’s Community Justice Partnership. A key part of the process is to evidence the work we are doing collectively and collaboratively.

More information on the process can be found at the Care Inspectorate’s website

To take this work forward, a lead team has formed and they are:
– Community Justice Partnership Chair (Police Scotland)
– Community Justice Coordinator (East Lothian Council)
– Group Service Manager (East Lothian Health & Social Care Partnership)
– Planning & Performance Manager (East Lothian Council)  and
– Justice Service Manager (East Lothian Council)

The self-evaluation focuses on three Quality Indicators and these are:
– 6.2 Planning and delivering services in a collaborative way
– 8.1 Effective use and management of resources
– 9.2 Leadership of strategy and direction

We are using three key questions throughout this process:
– How good are we now?
– How do we know?
– How good can we be?

Key activities to date
The Community Justice Partnership have reached a number of milestones in the process and these include:
– Developing an approach to the self-evaluation & validation process
– A briefing from the Care Inspectorate
– A Q&A session from the Care Inspectorate with Community Justice Partners
– Questionnaires returned from Community Justice Partners
– A Self Evaluation Development day with a wide range of stakeholders involved in community justice.

Timeline

For more information, please email us at communityjustice@eastothian.gov.uk

Self-Directed Support update (SDS) Update

SDS Thematic Review
East Lothian Health and Social Care Partnership (ELHSCP) was one of six Scottish health and social care partnerships to take part in a Care Inspection Thematic Review of the Implementation of SDS in Scotland. The Care Inspectorate visited East Lothian during September last year and worked with service-users, carers and staff to establish how well SDS was being implemented in the county. They had some very positive insights to share. They thought that the way that we supported people to experience positive personal outcomes through the implementation of self-directed support was good in East Lothian. Here’s what the inspectors had to say.

‘Good conversations and positive outcomes were clear strengths of our inspection findings in East Lothian. Staff…were confident that they were supporting people to achieve positive outcomes…many supported people and unpaid carers were clear that they were experiencing flexibility, choice and control in their care and support and that this was making a difference to their lives’.

They also noted that staff felt confident, competent and motivated to practice in an outcome-focused and person-led way. They rated us as good, saying:

‘The majority of social work staff we met…felt autonomous, confident and supported. There were appropriate arrangements in place to express views, share, discuss and reflect on practice issues at events, workshops and individual support levels with managers.’

Another area that impressed the inspectors was the way we had effectively communicated and engaged with our stakeholders and promoted more flexible commissioning strategies. They also liked the way that we empowered and supported staff to develop and exercise appropriate skills and knowledge, and they felt that leadership was good too.

They added:

‘The self-directed support vision, values and culture were generally well established across the partnership…Overall, the partnership was collaborative, innovative and had designed and embedded numerous new ways of working all based around efficiencies, market stimulation and self-directed support principles’.

East Lothian carer quoted by Care Inspectorate

SDS Action Plan
We re currently working on an action plan action plan to deliver the recommendations from the thematic review. In November, we will be holding an event for managers to work on the mapping process.

SDS Prepayment Card

SDS prepayment card
In January 2019, we introduced the SDS prepayment card. We put the amount agreed for the service-user’s four-weekly Direct Payment on to it every four weeks. It works like a debit card and has an online user account—just like an online bank account—and each card is PIN-protected.


With more people using Direct Payments, we need to put better, more efficient monitoring in place. The payment card will mean that no one will have to make quarterly submissions any more(and people will be able to check their balance online at any time). There will no longer be any need for people to open special bank accounts for Direct Payments, so it will be much quicker to set Direct Payments up. We think this system will be an added incentive for people thinking about or currently using SDS, as it will make finances much easier for service-users to control.

SDS Uptake

Leaving us soon…

Times they are a changing… In the next few months, we will be saying goodbye to several well-known (and well-loved) faces. Bryan Davies, our General Manager for Planning and Performance is joining NHS Screening Services as Associate Director and Carolyn Wyllie, acting General Manager for Older People and Access, is moving to take up a Head of Service Role with Adult Services at Stirling and Clackmannanshire Councils.

And Melissa Goodbourn from the Integration Team is beginning a two-year secondment in the Transformation Team (Adults with Complex Needs).

Congratulations to all of them – I know they are all leaving big shoes to fill. Watch this space for more information on who will be joining us in these roles.

Iain Gorman joins us as new Head of Operations

Iain Gorman is the new Head of Operations for East Lothian Health and Social Care Partnership. Iain began his career in NHS Dumfries and Galloway Primary and Community Care Partnership after completing a degree in Mathematics at St Andrews University and being successfully recruited onto the NHS Graduate Management Training Scheme. After completing his Masters in Leadership and Healthcare Management he accepted a position with NHS Greater Glasgow and Clyde as Clinical Service Manager for Endoscopy and Outpatient services. Iain in particularly proud of his involvement in the opening of the first patient facing services within the Queen Elizabeth University Hospital while in this role.

In 2016 Iain and his wife took the decision to move closer to family and Iain took on the post of Clinical Service Manager for General and Vascular Surgery in the Royal Infirmary of Edinburgh. Iain is proud father and family man. Outside of family life his 2 big passions are playing squash and Malt Whisky. Though he does admit that the two interests should not be enjoyed at the same time.

Over the last few years Iain has become interested in the challenges faced by community services and the need for Health and Social Care Integration. It was this growing interest which lead him to take on his new role.

Mental Health and Service Misuse Change Board Update

Key objectives:

  • Achieving a range of improvements of access, ongoing support and recovery for people experiencing difficulty and/ or distress related to mental ill- health or substance misuse issues

Update: Workforce scoping underway to identify training needs/resource required to begin to row out trauma-informed practice to Health and Social Care, Children’s Services, Primary Care, Housing and Community Development. 

Suicide Prevention Training will be delivered alongside given the complimentary nature of the input 

  • Addressing the health inequalities experienced by people with substance misuse needs, and those with poor mental health, particularly those with severe and enduring conditions

Update: Health Needs Assessment for East Lothian very recently completed by Public Health to inform our planning of the needs of the population in relation to substance misuse and sexual health needs

  • Collaboration with community justice to support those with poor mental health and/or substance misuse needs

Update: Following two public engagement events, the MH Reference Group is currently prioritising actions for year 1 of the action plan which will be reported to the January 2020 Reference Group, and subsequent Change Board

  • Improved access to a range of treatment and supports locally, i.e. in East Lothian and within the area partnerships across East Lothian

Update: Development of a service specification and development of an enhanced Grade 4 rehabilitation and recovery housing care and treatment support service, increasing access to this aspect of care for East Lothian by 50%.

Primary Care Change Board Update

Key objectives are:

  • Same day Triage and advice/consultation in support of Inveresk, The Harbours and Tranent practices, bringing a total of 52000 patients into the care model

Update: HIVE practices are in consultation over concerns about capacity in CWIC. This may delay rollout

  • Physio Practitioner and Primary Care OT led services available by self-referral/care navigation from all East Lothian GP practices, available same day to all East Lothian residents

Update: We have recruited five additional Primary Care (mental health) Occupational Therapists, who are now in post

  • Treatment Room nurse led services available by self-referral/care navigation from all East Lothian GP practices, available same day to all East Lothian residents

Update: Work on treatment-room nurse-led services is recruitment dependent

  • Paramedic and Nurse Practitioner led home visiting services in support of East Lothian GP Practices

Update: An ELHVIS pilot is in progress and further expansion likely to follow in 2020 dependent upon evaluation

  • Level 3 Pharmacotherapy Service for all East Lothian practices as specified in 2018 GP Contract

Update: There is a variable level of Pharmacotherapy support, with not all practices yet receiving support. Staff turnover and recruitment shortfalls relevant

  • Links worker service for all East Lothian practices as specified in 2018 GP Contract, by April 2020

Update: Pilot still running in four practices in west of county. Engagement with potential service providers and with service users including GP practices, in progress October 19. Service specification and tendering process to follow.