LOCALITY PLANNING: FINAL PROPOSALS · considers the funding required to support community capacity...

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AGENDA ITEM NO. 7

South Ayrshire Health & Social Care Partnership

Report to South Ayrshire Shadow Integration Board Meeting of 30th October, 2014

LOCALITY PLANNING: FINAL PROPOSALS 1. Purpose 1.1 The purpose of this report is to provide updated proposals for consideration by the

Shadow Integration Board (SIB), following a significant engagement exercise, on the proposed geographical boundaries of localities and neighbourhoods and on the roles proposed for each in the Strategic Planning (Commissioning) process.

2. Recommendation 2.1 It is recommended that the SIB (1) approves the locality and neighbourhood

boundaries as proposed in Appendix 5; (2) approves the roles proposed for the Locality and Neighbourhood levels in the Strategic Planning Process as detailed in Sections 6 and 7 of this report; (3) supports the recruitment and employment of three temporary officers to build capacity within communities in South Ayrshire in pursuit of the Integration Principles contained in the Public Bodies (Joint Working) (Scotland) Act, 2014 and in delivery of national and local outcomes for health and wellbeing for adults and for children; and (4) considers the funding required to support community capacity building (as proposed in Recommendation 3) when considering proposals on the utilisation of Transitional Funding in 2014-15 and, similarly, in respect of proposals to be brought forward for use of the new Integrated Care Fund in 2015-16.

3. Background Information 3.1 The Shadow Integration Board (SIB) at its meeting on 24th April, 2014 considered a

report on locality planning and agreed to approve the approach to this detailed therein and further, that Officers proceed with a planned engagement exercise for Stakeholders on the draft proposals.

3.2 This earlier report explained in terms of the Health and Social Care Partnership that:

3.2.1 Locality planning is a key element of Health & Social Care Integration and with the enactment of the Public Bodies (Joint Working) (Scotland) Act, 2014 has become a legal requirement in relation to the planning and delivery of health and social care services. Partnership Strategic Plans will require to provide details of the way in which statutory partners plan to commission services in identified localities.

3.2.2 The legislation requires that the Strategic Plan to be adopted by the

Partnership Integration Joint Board after 1st April, 2015, should achieve the following:-

strategic plans will divide each local authority area into at least 2 localities;

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strategic plans will set out separately the arrangements for carrying out integration in each locality;

services set out in the Strategic Plan should reflect local needs and resources;

the Strategic Plan should take account of the different needs of different people in each area;

localities must be able to influence the content of Strategic Plans; and

local needs must be fed into the strategic commissioning process.

3.2.3 In working towards the delivery of the new National Outcomes for Health & Social Care, the Act states that services and support should be planned and provided in a way that is consistent with the Integration Principles which are set out within it and specifically in this context:-

(a) that the main purpose of services which must or may be provided in

pursuance of the integration functions for the council area is to improve the wellbeing of recipients; and

(b) that those services should be provided in a way which:-

takes account of the particular needs of different recipients;

takes account of the particular needs of recipients in different parts of the area in which the service is being provided; and

is planned and led locally in a way which is engaged with the community and local professionals;

3.2.4 For Strategic Plans to take account of local needs and resources and the

different needs of different people in each area, there will require to be effective engagement with all key stakeholders at a range of different levels, each with its own unique purpose within the strategic planning process. Specifically in terms of a locality based approach to planning, a two-tier approach was proposed to the SIB based on Localities and Neighbourhoods.

3.2.5 A diagram illustrating different levels and functions in the Strategic/Locality

Planning process is detailed below in Figure 1:

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3.2.6 At its meeting on 24

th April, 2014, the SIB agreed that Locality Planning in

the South Ayrshire Partnership would have two main purposes:

One will be to jointly assess need, prioritise and plan how all resources, irrespective of their origin, can best be deployed in pursuit of the delivery of the National Outcomes for Health & Social Care.

The second purpose ascribed to locality planning in South Ayrshire will be the local delivery of services and support to the population or communities within the area concerned. These services and support may be provided through the statutory, independent, or voluntary sectors, or from within or between local communities.

4. Engagement Exercise 4.1 In respect of the proposals contained in the earlier report, the Shadow Integration

Board approved the approach proposed and to follow this with an extensive stakeholder engagement exercise over the spring and summer months. It was further agreed that the results of this exercise would be written up and presented to the Board at a subsequent meeting with a view to the agreed approach to locality planning becoming a part of local approach to Health & Social Care Integration. The following timeline was approved:-

4.2 At the SIB meeting on 26th August, 2014 it was agreed to extend the period of the

engagement exercise and to consider a follow-up report at its meeting on 30th October rather than in August as had been originally intended.

1. Sign-off of Project Brief – 31st January, 2014.

2. Project launch – by 15th February, 2014.

3. Individual agency positions established and existing information on need within community areas provided – by 14th March, 2014.

4. Creation of Joint Inter-Agency Working Group and scoping out of outline proposals for consultation and engagement – by 11th April, 2014.

5. Seek approval from Shadow Integration Board (SIB) to proposed Locality

Planning Framework and to scope and purpose of Stakeholder Engagement

Exercise – by 30th April, 2014.

6. Engagement with stakeholder groups – 1st May to 18th July, 2014.

7. Refinement of draft proposals – 21st July to 1st August, 2014.

8. Preparation of final report for Shadow Integration Board approval on

framework, scope and terms of reference for localities: 4th – 29th August,

2014.

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4.3 During the summer months extensive engagement has taken place with a range of individuals and groups representing local communities, professionals, staff, independent contractors, the Voluntary Sector and the Independent Sector. A list of those engaged is provided in Appendix 1.

4.4 Engagement with some groups such as GP‟s and individual Community Planning

Partners is on-going. Those Community Planning Partners engaged to date have generally been supportive of the proposals contained in this report (see Appendix 1 for organisation details.) Actual participation around the locality planning table is more likely by those Partner Organisations based locally or who have local service delivery points. Other nationally based Partners while supportive of the objectives being pursued are more likely to support the process through the provision of information to assist with planning or participation in specific proposals. Strathclyde Passenger Transport (SPT) have indicated that transport within the proposed localities should not be an issue as they are all served either through commercial transport provision or where coverage is not as comprehensive, by SPT supported services.

4.5 The engagement exercise has been centred around a presentation on the Council‟s

Community Engagement Strategy and the Partnership‟s Locality Planning proposals and how community engagement could be effectively undertaken within the context of a locality based approach. The engagement exercise has been led by Officers from the Council and the NHS who comprise the Joint Officers Group on Locality Planning. The Group has developed the proposed approach. Care has been taken by the Group to ensure that the proposals approved by the Council on its approach to Community Engagement and these community planning proposals are complimentary to each other and senior Council Community Engagement and Community Planning staff have been part of the Joint Officers Group on Locality Planning.

4.6 Generally speaking, the response to the principles being proposed as articulated in

the joint presentation have been well received and supported albeit with a healthy degree of scepticism particularly on the part of some community groups regarding the likelihood of public bodies following through on the proposals being made. A summary of responses received is provided at Appendix 2.

4.7 In addition to the face to face meetings, a postal and on-line survey was conducted

which elicited a small number of responses. A summary of this is provided at Appendix 3.

4.8 As a result of the comments and feedback received through the engagement

exercise, the Joint Officers Group on Locality Planning proposes to amend its original proposals and more is said about this in the next section of this report.

5. Proposals

5.1 In the earlier report 6 localities were proposed along with 24 neighbourhoods as

specified in Appendix 4. The neighbourhoods were based around existing Intermediate Data Zones as it is felt important that the Partnership is able to provide local groups with information on which to base their consideration of needs and priorities in their individual areas or communities.

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5.2 On the basis of the feedback received, it is intended to retain the proposal to have six localities, but to change the boundaries of these as detailed in Appendix 5 and also, to reduce the number of neighbourhoods to 23 by regarding the Town of Girvan as one neighbourhood.

5.3 In a small number of rural communities the neighbourhood boundaries will no longer

by synchronous with the boundaries of the Intermediate Data Zones and this is an issue which will require to be addressed by the Partnership in due course as it develops its systems for strategic planning and performance monitoring. For example, Loans, Dundonald and Symington are currently part of the one data zone, but it is intended to split this between two localities, as those living within the areas and those representing and working within the communities have, on the whole, advised that this would be more in line with how people see their communities and where they access health services, for example.

5.4 A map showing the areas of the updated localities being proposed forms Appendix 6

to this report along with more detailed maps for each locality highlighting the location of existing health, council and provider service access points and staff bases related to the Integration Functions that will be delegated to the Integration Joint Board.

5.5 Initial profiles for each of the six localities are attached at Appendix 7. (These will

be updated with recently received data.) 6. Role of the Locality Level in the Locality Planning Process 6.1 As previously indicated, the legislation requires that South Ayrshire is divided into

localities for the purpose of preparing a Strategic Plan. The requirement to undertake this planning at a local level in a way that takes account of the needs and individual characteristics of particular areas, while balancing this objective with the need for efficiency and effectiveness in the planning, commissioning and resourcing of services, can best be achieved, it is suggested, at the locality level (see Figure 1 on page 2).

6.2 This would be the level at which greater „service‟ engagement would be enabled, for

example, GP practices, pharmacies, third sector „hubs‟, district nursing teams, and social work/home care. This is where links to institutional care (such as care homes) will be more formally made.

6.3 In general terms, the role of the locality level within strategic planning will be to

assess identified need; to plan for how these needs should be addressed; to commission services; prioritise service delivery and expenditure by balancing community based priorities with those proposed by the full range of professionals and providers, while taking account of the requirements of legislation and policy; and to monitor performance in relation to outcomes and objectives. Planning work at locality level will be informed, in part, by information on identified needs from each neighbourhood and by the priorities listed in Neighbourhood Action Plans (see Section 7). There will be a plan produced for each locality which will become an integral part of the overall Partnership Strategic Plan. Each locality plan will cover a three-year period and be updated annually. Periodic progress updates will be provided to Locality Planning Groups on locality plans.

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6.4 In a change to the original report, it is now proposed that Locality Planning Groups will no longer be formal working groups of the Partnership Integration Joint Board, but instead will be part of the membership of the Strategic Planning Group which is the representative body that will inform and help shape the content of the overall Strategic Plan. However, as proposed in the earlier paper, it is felt the Locality Planning Group should be chaired by a voting member of the Board and he/she should act as a champion for the locality on the Integration Joint Board.

6.5 Each neighbourhood within a locality will be represented on the Locality Planning

Group, together with representation from the 3rd and Independent Sectors and a range of professionals and providers, including GP practices, pharmacists, dentists, AHP‟s, nurses, social workers and home carers. If not represented through neighbourhood representation, carers and patients/service users will also be represented. The Director of Health & Social Care and his staff team will support the work of the Locality Planning Groups. Each locality planning group should meet regularly throughout the year.

6.6 Until sufficient information on need in South Ayrshire and within the proposed

localities is available to fully inform the Strategic Planning process from the Government‟s Information Services Division (ISD), and others, it is not being proposed that resources or control of resources be delegated to Locality Planning Groups at this time. Whilst it is has been identified nationally that this is a key element of the locality planning approach, it is recommended for the reason given that the timing of this be considered by the Integration Joint Board during the lifetime of the first Partnership Three-year Strategic Plan. On this basis, therefore, at least, initially, no responsibility for the commissioning of services will be delegated from the Integration Joint Board to Locality Planning Groups.

7. Role of the Neighbourhood Level in the Locality Planning Process

7.1 The role of the neighbourhood level within locality planning will be to assess

identified need in terms of issues relating to health and social care; to suggest how these needs might be addressed; to prioritise the needs on the basis of what is most important to the local community; to be supported in this task, as necessary, by identified clinicians and professionals from the statutory sector and by representatives of the 3rd sector; to be informed by the views of service users and carers; to monitor performance in relation to prioritised actions and objectives; and to reflect all of these within an agreed action plan for the neighbourhood.

7.2 Those with an appropriate interest in health and social care in a community at the neighbourhood level would be invited to join a Neighbourhood Planning Group. This could be an existing group within the local community if it is sufficiently inclusive.

7.3 It is expected that this Group will comprise community representatives, nominees

from appropriate local groups, clinicians and professionals (on an as required basis), 3rd Sector representatives, and people representing service users and carers.

7.4 Ideally the support for the Group will be provided from within the neighbourhood with initial support from Partnership officers. It is recognised that capacity building in this regard may be required for a period before a group could become self-sustaining and more will be said about this later in this report. An on-going programme of community capacity building will be tailored to meet the needs of new members and their organisations.

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7.5 The delivery of National Outcomes will require more people to be supported at home within their local communities and for there to be a greater sense of well-being within each of these through greater emphasis on prevention and staying well. Achieving this is in part about disease prevention, but not just, it is about ensuring that people live fulfilling lives at home with the company and support they require. Much of this could be co-produced in local communities making use of local assets. If Partnerships are to be successful in shifting the balance of care away from hospitals and other institutions to local communities, it is at this neighbourhood level that this fundamental shift will require to be encouraged and secured.

7.6 Such an approach will require resources and it is proposed that a modest Change or

Integration Fund be provided by the Integration Joint Board within each neighbourhood to be allocated in pursuit of these objectives in accordance with agreed action plan priorities.

7.7 A diagram summarising the roles of the various levels within the Strategic Planning

process is outlined at Appendix 8. 8. Service Delivery Hubs

8.1 While it is proposed for strategic planning and commissioning purposes that six

localities be formed, it is not intended to mirror this structure in terms of service delivery, where, currently, in terms of efficiency, the proposal is to consider the development of 3 delivery hubs based in Ayr, Girvan & Troon or Prestwick.

8.2 These service delivery arrangements will be informed by the new management

structure for the Partnership to be developed by the Director of Health & Social Care and his Senior Management Team and brought forward in due course for SIB/IJB consideration.

9. Resourcing Future Development & Community Capacity Building 9.1 As there has, to date, been no systematic locally based element of the approach to

Community Planning within South Ayrshire, there is, currently, not a uniform or comprehensive support network in place to sustain and develop this level of involvement. There are, however, some examples of such support and capacity existing within a small and limited number of neighbourhoods, particularly those identified as suffering from multiple deprivation.

9.2 For example, a temporary Community Connector employed through Voluntary Action

South Ayrshire (VASA) utilising temporary Government funding to 31st March, 2015, is currently mapping and recording existing community groups and community based support. However, this work is scheduled to end when the funding ends at the conclusion of this financial year.

9.3 VASA also employ an officer whose role it is to support new Social Enterprises in

South Ayrshire and a part-time staff member supports community capacity building. 9.4 Within South Ayrshire Council activity is focussed on Community Safety and a small

number of Community Engagement staff encourage and support engagement activities in a North Ayr and in other specific parts of the local authority.

9.5 In Health most public engagement activity is focussed around the acute sector.

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9.6 As has been alluded to in this report, if Integration is to succeed in terms of its central purpose of shifting the balance of care away from the acute to the community sector, there has to be sufficient capacity or assets within local communities to engage in co-production designed to support people at home in their neighbourhoods in a way that is rooted in prevention across the whole of South Ayrshire.

9.7 This capacity will require to be developed and nurtured and additional resources will

be required for this purpose which will be achieved through the creation and the sustaining of the neighbourhood planning groups referred to earlier. To achieve this, it is being recommended that three temporary community capacity (development) posts be created and filled by the Council on behalf of the Partnership at an early date should this report be agreed by the SIB. Given this timetable, recruitment would be unlikely to be before 2nd February, 2015.

9.8 Full year salary costs of three such posts would be likely to be in the order of

£110,000, including on-costs. In 2014-15 costs will be around £30,000, including travel and initial set up. At current prices, future full year costs from 2015-16, including an allowance for travel, is likely to be in the order of £112,000.

9.9 It is proposed that £30,000 in 2014-15 be funded from the Integration Transition

Funding for 2014-15 provided by the Scottish Government of which there is £89,000 available to the South Ayrshire SIB. A separate report on the proposed utilisation of this forms Agenda Item 8 for this meeting of the SIB.

9.10 A new Integrated Care Fund is being established in 2015-16 by this Scottish

Government. Currently funding is for one-year, although indications are that this may be extended following the Comprehensive Spending Review. To be eligible for

funding projects must comply with a range of criteria including: “Central to these approaches must be the shift to support the assets of individuals and communities so that they have greater control over their own lives and capacity for self-management, particularly of multiple conditions.” The Fund Guidance adds in terms of localities – “the locality aspects must include input from professionals, staff, users and carers and the public. Partnerships should develop plans with the people who best know the needs and wishes of the local population. Such a bottom-up approach should maximise the contribution of local assets including the third sector, volunteers and existing community networks. Partners will be expected to weight the use of their funding to areas of greatest need.”

9.11 The Director of Health & Social Care will recommend to the SIB when it considers its

Plan for the utilisation of this Fund at its meeting in November, that funding of around £120,000 be included for this purpose. If the Fund is extended beyond next financial year, it would be intended to seek authority to extend the contracts of the temporary employees recruited for them to be in place for the full period of the funding.

10. Conclusion 10.1 Should the SIB approve the recommendations contained in this report, the focus

going forward will be:

(a) to communicate the final proposals agreed as widely as possible within South Ayrshire ensuring that feedback is provided to all who participated in the engagement exercise;

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(b) to take steps to form the six locality planning groups in the period to 1st April, 2015 and to ensure that these are in a position to start to play the role described in this report from that date;

(c) to seek to bring together interested groups and individuals at

neighbourhood level and to seek to build and sustain capacity to enable them to undertake the role envisaged in terms of neighbourhood planning;

(d) to continue to identify information and information sources and to make

this available in a way and in a form that will inform the work of neighbourhood and locality planning groups and enable them to make a significant contribution to the Strategic Planning (Commissioning) process; and

(e) to continue to listen to the full range of stakeholders in a way which sees

locality planning continue to evolve as the Partnership becomes more established and to report to future meetings of the Integration Joint Board on potential improvements and developments in the approach.

11. Resource Implications 11.1 Potential resource implications in terms of both funding and people have been

outlined in Section 9 of this report. In summary, it is proposed that £30,000 of Transitional Funding from the Scottish Government be utilised to fund Community Capacity Building in 2014-15 and that further with SIB approval, that £112,000 be made available from the Integrated Care Fund in 2015-16. Should this Fund be extended beyond next financial year, it is also being recommended that funding from this source for community capacity building should be similarly extended.

12. Consultation 12.1 There has been considerable consultation on the proposals contained in this report as detailed in paragraph 4.3 and at Appendix 1.

Background Papers Public Bodies (Joint Working) (Scotland) Act, 2014 Report to Shadow Integration Board on 24

th April, 2014, entitled

“Locality Planning” Person to Contact Bill Gray, Project Planning & Performance Manager, County

Buildings, Wellington Square, Ayr Tel 01292 612962 e-mail: [email protected]

Date: 10th October, 2014

mailto:[email protected]

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Appendix 1

Engagement Exercise – Public/Groups/Organisations Consulted

Group Alcohol and Drugs Partnership Allied Health Professionals Carrick Community Councils Forum Community Safety Partnership Community Planning Implementation Group Community Planning Partnership Board Dieticians District Nurse TLs Elected Members Faith Community Event Girvan Community Hospital Forum Girvan SW Staff GP South Locality Group GP Practice Managers Barns GP Practice Health and Social Care Staff Engagement Event Learning Disability SAC/NHS Staff Mirror Theme Groups (3

rd Sector)

Prestwick Community Council Public - Ayr - Lochside Public – Ayr Academy Public – Coylton Public – Girvan Public – Maybole Public – Prestwick Public – Symington Public – Tarbolton Public – Troon Public Health Staff Public Partnership Forum School Nurses/HVs Scottish Care – Independent Sector Scottish Enterprise Scottish Fire & Rescue Service Ayrshire College Skills Development Scotland Strathclyde Passenger Transport

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Appendix 2 Locality Planning: Feedback from Engagement

Group Key points

Health & Social Care

Professionals & Wider

Staff Groups

Generally positive response.

Concerns about level of capacity in AHP professions to engage – particularly professions with smaller numbers.

Some issues with particular boundaries (e.g. Coylton).

Particular attention needs to be paid to more challenging groups with particular needs such as Learning Disability at partnership (and A&A) level as well as at localities.

Some comments made that suggest linking a lot of the reform agenda to budget cuts.

They seem a natural fit, with just a few anomalies of neighbourhoods. Would Heathfield not be a more natural fit with Troon and Prestwick and Newton North with Ayr North?

Although understand reasons for groupings and the decision to have two „Ayr‟ localities, does this not somewhat limit the opportunities for increasing better social inclusion for communities?

The supporting presentation refers to delivering on need, but what kind of infrastructure will be able to support this within the current financial constraints?

Resource implications need to be considered. The locality model is predicated on the workforce having the necessary community development and community engagement skills. But that is not in place. Although capacity building is referred to in the supporting information, this is crucial to the success of this approach.

The challenge of, for example, co-production and the adoption of this locally also needs to be taken in to consideration. The proposal needs to consider building capacity for prevention, anticipatory care and self management.

The villages in the proposed Kyle locality are individually different to each other and more likely to engage as Dundonald, Loans and Symington in Troon Locality and Annbank and Mossblown in Ayr North Locality. Given this, perhaps Troon & Prestwick should be part of separate localities.

The boundaries for North and South Carrick should be amended to reflect school catchment and doctor‟s surgery use, notably moving the North Carrick border further south to the Dailly/Turnberry area.

Public Events and

Representative/Community

Groups

Generally positive reception although limited numbers in attendance.

Sceptical as to delivery and intent on part of public bodies and Council in particular.

Better to think of Girvan as one entity.

Strong feeling to include surrounding villages as named communities rather than a collective South Carrick Villages.‟

Consultation may have been better date matched with other events which were already occurring rather than competing with them.

General concept of localities well received for service planning.

Suggestion that Coylton was more affiliated with Ayr (Holmston/Forehill) rather than Kyle.

Change of culture – public believe decisions have already been made prior to consultations.

Opportunity to take an element of control and keep the conversation going.

Only limited by our imagination – need to move to more support from people within communities for communities.

Loans, Symington & Dundonald needs to be under Troon/Prestwick locality.

Need to find and target local champions.

Concerned that Seafield wouldn‟t get the services that Lochside gets because it doesn‟t have the same level of deprivation.

Local communities have no idea what is happening in their communities.

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Commented positively on the amount of work that had been done in the Maybole area.

Charities staffed by local people have more passion about what they do, instead of involvement from large outsider organisations.

The neighbourhoods should be „Prestwick North‟ and „Prestwick South‟ rather than the proposed „Prestwick East‟ and „Prestwick West‟.

Loans should be with Troon.

Sounded too top heavy.

Where does procurement fit into this geographical split – is there going to be a process taking into account local provision. Best practice so that local people are employed in local positions.

The event was not well attended because historically nothing has ever come of anything in the past.

Hospice concerned about what impact this may have on its ability to provide service in localities.

Symington should be linked to Prestwick.

Annbank, Mossblown & Tarbolton link to Ayr.

Concern those in small villages would not get the same level of care and attention.

Keen on Small Grants suggestion.

Now a need in the village for services like befriending.

Suggested Kyle locality needs to go.

Need to ensure engagement with the widest spectrum of the community.

Lose the traditional methods of Community Planning. Use more social media, be more innovative.

Newton North should be included in Ayr North.

Big concerns about transport links.

St Quivox should not be in Lochside.

Elected Members Concerned about proposal to include Coylton in Kyle locality.

Queries were raised about the terms of reference for locality groups.

Concern was raised about Heathfield being in proposed Ayr locality.

Concern was expressed about the geography of the proposed Carrick South locality.

Ensure information is in plain English.

A question was asked regarding remuneration arrangement for Integration Board members.

Clarification was sought on how the localities will engage with charitable organisations and third sector groups.

Partnership Bodies Request for locality based work to be done under a broader Community Planning banner.

Some reservations re particular areas (e.g. Carrick).

Generally positive although some of the presentation was quite new for some members.

Place of ADP and alcohol and drugs related work in new Partnerships?

Main feeling was retaining Kyle area, but putting Loans in with Troon.

GP South Locality Group Small numbers of GPs were in attendance.

Independent Sector Reasonable acceptability of locality working proposals and locality areas in outline.

More interest in the service delivery end – e.g. Hub supports.

Mirror Theme Groups (3rd

Sector)

This shouldn't be to the exclusion of other social welfare needs. (i.e. Housing)

Recognition of the unheard - ensure everyone's opinion are considered.

Planning must include the unengaged.

Lack of engagement from Local GP - Older peoples first contact.

Under Representation of vulnerable people within community groups - How does this fit using existing groups?

Ensure strong support networks for community groups, training, education etc.

Needs should be identified by the group members.

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Take out the jargon.

Capacity at every level (Aspiration -v- Real World).

Influence & decision making. (Delegated powers & budgets)

Needs to be service user led.

Creative approach - new ways of working in an integrated way.

Revitalise & energise /support locality groups.

Representation across community /equal voice.

Somewhere to start - go for it.

Good Idea if it works, but why is it only dealing with Health & Social Care?

Clear channels of communication - everyone knows what is going well or not.

Community development within weaker areas.

Positive incentives & feedback to local groups - training opportunities, not talking shop.

Empowerment of the local people.

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Appendix 3

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Appendix 4

Original Localities & Neighbourhoods Proposed

Troon & Prestwick Troon Barassie Muirhead Prestwick Airport & Monkton Prestwick East Prestwick West

Ayr Alloway and Doonfoot Ayr South Harbour and Town Centre Belmont Castlehill & Kincaidston Heathfield Holmston & Forehill Newton North

Ayr North Ayr North Harbour, Wallacetown & Newton South Dalmilling & Craigie Lochside, Braehead & Whitletts

Kyle Annbank, Mossblown & Tarbolton Dundonald, Loans & Symington Coylton North Carrick Maybole North Carrick Girvan & South Carrick Girvan Ailsa Girvan Glendoune South Carrick

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Appendix 5

New Localities and Neighbourhoods being Proposed

Troon Troon Barassie Muirhead Dundonald & Loans Prestwick Prestwick Airport & Monkton Prestwick East Prestwick West Symington Heathfield Newton North

Ayr North & Former Coalfield Communities Ayr North Harbour, Wallacetown & Newton South Dalmilling & Craigie Lochside, Braehead & Whitletts Annbank, Mossblown & Tarbolton

Ayr South & Coylton Alloway and Doonfoot Ayr South Harbour and Town Centre Belmont Castlehill & Kincaidston Holmston & Forehill

Maybole & North Carrick Maybole North Carrick Villages – Fisherton, Dunure, Maidens, Kirkoswald, Turnberry, Minishant, Kirkmichael, Crosshill and Straiton. Girvan & South Carrick Girvan South Carrick Villages – Dailly, Barr, Colmonell, Lendalfoot, Ballantrae, Barrhill & Pinmore.

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Appendix 6

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Appendix 7

LOCALITY PROFILE: TROON Neighbourhoods Included: (1) Troon; (2) Muirhead; (3) Barassie; (4) Dundonald and Loans

Population: (see Note 1 below) 20,263

Percentage of South Ayrshire Total: 17.96

Older Population: (see Note 2 below)

The older population in Barassie and Troon exceeds the South Ayrshire average, but in Muirhead and in Dundonald and Loans it is below average, albeit just in the case of the latter.

Overview of Economic Issues: (see Note 3 below) Across this Locality other than in Barassie figures for employment and income deprivation are below the South Ayrshire average. This position is largely repeated in relation to the range of benefits claimed.

Life Expectancy: (see Note 4 below)

Life expectancy for males is at or above the average for South Ayrshire other than in Barassie where it is one year below average. Life expectancy for females is at the average or above average across the Locality.

Health Conditions Leading to Death: (see Note 5 below)

Deaths from Coronary Heart disease are above average in Dundonald and Loans. In terms of deaths from Cancer these are only below average in the same neighbourhood. Deaths from Cerebrovascular disease are above the average in Muirhead and Troon.

Rate of Hospital Admissions: (see Note 6 below)

Emergency admissions across all age rages are above the South Ayrshire average in Barassie and Troon. This position is repeated in terms of the over 65‟s although these are also above average in Dundonald and Loans. Admissions from accidents are higher than average in Troon and in Barassie.

Causes of Hospitalisation: (see Note 7 below)

Patients hospitalised with alcohol and drug conditions are above average in Barassie. Coronary heart disease, cancer and cerebrovascular admissions are above average in all but Muirhead. Respiratory disease admissions are above the South Ayrshire average in Barassie as are diseases of the digestive system. Patients hospitalised with Asthma are above average in Barassie and in Dundonald & Loans.

Other Matters: (see Note 8 below)

The prevalence of diabetes is below the South Ayrshire average across the Locality.

Crime & Justice Profile (see Note 9 below)

Crime and justice rates are below average across the Locality.

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LOCALITY PROFILE: PRESTWICK Neighbourhoods Included: (1) Heathfield; (2) Newton North; (3) Prestwick Airport & Monkton; (4) Prestwick East; and (5) Prestwick West




The proportion of older people living in Prestwick and Monkton is above the average for South Ayrshire as a whole. In Heathfield and Newton North the corresponding figures are below the average.

Overview of Economic Issues: (see Note 3 below) People in this Locality are below the South Ayrshire average in terms of employment deprivation. The position on income deprivation is similar other than in Newton North where the figure in this regard is slightly above average. On benefits people in Prestwick and Monkton claim lower levels of benefits across the spectrum than is the case across South Ayrshire, however, this position is not replicated in Heathfield and Newton North where in some cases figures are above the average.


Other than in Newton North, life expectancy in this locality is above the South Ayrshire average for both males and females.


Deaths from Coronary Heart Disease are lower than average across the Locality with the exception of Heathfield where they are above the average. Deaths from Cancer and Cerebrovascular Disease are above the South Ayrshire average in Newton North and Prestwick East. An above average percentage of the populations in Newton North and Heathfield are prescribed drugs for anxiety, depression or psychosis.


Emergency hospital admissions across all age ranges is lower than the South Ayrshire average across the Locality other than in Prestwick Airport and Monkton where they are above the average. In terms of the over 65s the rate of hospital admissions is higher than the average in Heathfield, Newton North and Prestwick Airport. Admissions as a result of accidents exceed the average in Prestwick West.


Coronary heart disease admissions are above the average for South Ayrshire in Heathfield, Newton North and Prestwick East. Cerebrovascular admissions are above average in Heathfield, Prestwick & Monkton and in Prestwick East. Cancer related admissions are higher than average in Prestwick East and significantly above average in Prestwick West. Admissions due to diseases of the digestive system are above average in Prestwick Airport and Monkton. Patients hospitalised with Asthma are above the south Ayrshire average in Newton North.

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The prevalence of diabetes is above average in Newton North.


Crime and justice statistics are below the average for South Ayrshire across this locality.

LOCALITY PROFILE: AYR NORTH & FORMER COALFIELD COMMUNITIES

Neighbourhoods Included: (1) Ayr North Harbour, Wallacetown & Newton North; (2) Dalmilling & Craigie; (3) Lochside, Braehead and Whitletts; and Annbank, Mossblown & Tarbolton




Overall the number of older people is below the South Ayrshire average. In Lochside, Braehead and Whitletts the figure is significantly below.

Overview of Economic Issues: (see Note 3 below) Excluding the former Coalfield Communities, there are high levels of income and employment deprivation in the Locality. In Annbank, Mossblown & Tarbolton the numbers are above average, but not significantly so. The number of people claiming benefits in all age ranges and across a wide range of different benefits in Ayr North is well above the South Ayrshire average. In the former Coalfield Communities the figures are generally, but not always, above average.


In all four Neighbourhoods comprising this Locality, male life expectancy is below the South Ayrshire average. In Lochside, Braehead and Whitletts and in the former Coalfield Communities female life expectancy is also at a reportable level below the average for South Ayrshire.


In all three Ayr North Neighbourhoods deaths from coronary heart disease and cancers are above average. In the former Coalfield Communities cancer deaths are slightly above average by comparison and deaths from coronary heart disease is below the South Ayrshire average. In all but Ayr North Harbour, Wallacetown & Newton North deaths from Cerbrovascular disease are also above the South Ayrshire average.


Emergency admission rates to hospitals for all age ranges and for older people across this Locality are above average rates for South Ayrshire. Admissions as a result of accidents are also above average except in the former Coalfield Communities.


Those hospitalised for conditions related to use of alcohol and drugs is significantly

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above the South Ayrshire average across the Ayr North area. In the former Coalfields area, hospital admissions relating to alcohol are above average, but admission rates for drug related conditions are below average. Admissions related to Coronary Heart Disease are above average except in Lochside, Braehead and Whitletts and in the former Coalfield Communities. Admissions related to Asthma are above average for South Ayrshire throughout the Locality. Respiratory disease admissions are also above average except in Dalmilling and Craigie. Admissions relating to digestive system issues are above average except in Ayr North Harbour, Wallacetown and Whitletts.


The prevalence of diabetes in the Locality is above the South Ayrshire average other than in the former Coalfield Communities. The number of teenage pregnancies exceeds the South Ayrshire average across this Locality. Women smoking when becoming pregnant also exceeds the average across the Locality.


Statistics for crime and justice issues in North Ayr present negatively when compared against average figures for South Ayrshire as a whole. In the former Coalfields area the crime rate is below the South Ayrshire average.

LOCALITY PROFILE: AYR SOUTH & COYLTON Neighbourhoods Included: Alloway & Doonfoot; South Harbour & Town Centre; Belmont, Castlehill & Kincaidston; Holmston & Forehill and Coylton




In Alloway & Doonfoot, South Harbour & Town Centre and Belmont the percentage of older people within these neighbourhoods exceeds the South Ayrshire average. In the rest of the locality the number of old people is at or below the average.

Overview of Economic Issues: (see Note 3 below) In South Harbour & Town Centre and Castlehill & Kincaidston levels of income and employment deprivation in these neighbourhoods exceed the South Ayrshire average. In the remainder of the Locality levels are below the average and in Alloway and Doonfoot they are well below. This position is largely replicated in terms of the range of benefits claimed.


Across the Locality male life expectancy is generally at or in excess of the South Ayrshire average. Highest male life expectancy is in Alloway and Doonfoot at 5.5 years above average. Female life expectancy is similarly in excess of the average other than in South Harbour and Town Centre where it falls short by around 3.5 years. Highest female life expectancy is in Coylton at 7.1 years above average.

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Deaths from coronary heart disease are below average other than in South Harbour and Town Centre. Deaths from Cancer are above the South Ayrshire average in Belmont and Castlehill and Kincaidston. In other parts of the Locality they are below average. Cerebrovascular deaths are higher than average in South Harbour & Town Centre and in Belmont and lower in all other parts of Ayr South and Coylton. The proportion of the population prescribed drugs for anxiety, depression or psychosis is above average in this Locality with the one exception of Alloway and Doonfoot.


Emergency hospital admissions for all ages are higher than the South Ayrshire average in South Harbour & Town Centre and in Castlehill & Kincaidston. This is also the case for admissions due to accidents. In all other neighbourhoods the figures are below the average. In the over 65‟s hospital admissions are also above average in Belmont.


Patients hospitalised with alcohol related conditions are above average in South Harbour and Town Centre. This is also the case in terms of drugs related admissions and in addition these admissions are above average in Castlehill and Kincaidston. Coronary Heart disease admissions are above average in South Harbour & Town Centre and in Castlehill & Kincaidston. Cerebrovascular admissions are higher than the South Ayrshire average other than in Coylton and Holmston and Forehill. Cancer admissions are higher in all areas other than in Castlehill & Kincaidston and in Holmston & Forehill. Respiratory disease admissions are higher than average in South Harbour & Town Centre and in Castlehill & Kincaidston, as are diseases of the digestive system which are also above average in Coylton. Hospitalisation from Asthma is above the South Ayrshire average in Castlehill & Kincaidston and in Coylton.


The prevalence of diabetes is above average in Coylton and in South Harbour and Town Centre. Women smoking when becoming pregnant is above the South Ayrshire average in Castlehill and Kincaidston.


Crime and justice rates are well below the South Ayrshire average in this locality other than in South Harbour and Town Centre where they are well above average.

LOCALITY PROFILE: MAYBOLE & NORTH CARRICK Neighbourhoods Included: (1) Maybole; and (2) North Carrick Villages




Overall the number of older people is below the South Ayrshire average.

Overview of Economic Issues: (see Note 3 below)

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There are lower than average levels of income and employment deprivation in the rural area that comprise the Locality. In Maybole levels are above the South Ayrshire average. Similarly the number of people claiming benefits in all age ranges and across a wide range of different benefits is above average in Maybole and generally below average in the remainder of the locality.


In Maybole, male life expectancy is well below average. In the North Carrick Villages, female life expectancy is below average.


In Maybole deaths from coronary heart disease and cancers are above average. In the North Carrick Villages deaths from Cerbrovascular disease are above the South Ayrshire average.


In Maybole emergency admission rates to hospitals for all age ranges, but especially for older people are above average rates for South Ayrshire as are admissions as a result of accidents. In the remainder of North Carrick they are lower than the average.


In Maybole hospital admissions for Asthma are above average as are respiratory disease admissions. In the rural area admissions for diseases relating to the digestive system are slightly above average.


The prevalence of diabetes in Maybole is above the South Ayrshire average. The percentage of women smoking at the commencement of pregnancy in Maybole is higher than the South Ayrshire average.


Statistics for crime and justice issues in this Locality present positively when compared against average figures for South Ayrshire as a whole, other than in Maybole where figures are above average.

LOCALITY PROFILE: GIRVAN & SOUTH CARRICK Neighbourhoods Included: (1) Girvan; and (2) South Carrick Villages


Percentage of South Ayrshire Total: 11


Overall the number of older people is above the South Ayrshire average.

Overview of Economic Issues: (see Note 3 below) There are lower than average levels of income and employment deprivation in the South Carrick Villages. In Girvan levels are above the South Ayrshire average. Similarly the number of people claiming benefits in all age ranges and across a wide range of different benefits is above average in Girvan and generally below average in

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the remainder of the locality.


In Girvan, average life expectancy for males is below the average for South Ayrshire.


Deaths from Coronary heart disease are above the South Ayrshire average across the Locality. Cancer deaths are a bit above average in Girvan, but well below average in the remainder of the Locality.


In Girvan emergency admission rates to hospitals for all age ranges are above average rates for South Ayrshire as are admissions as a result of accidents. In the South Carrick Villages the equivalent rates are below average.


Across the Locality admission rates for Cerebrovascular and Respiratory disease is above average and in Girvan admission for diseases relating to coronary conditions, cancers, digestive system complaints and to Asthma are all above the South Ayrshire average, as are admissions relating to alcohol and drug use.


In Girvan there is a higher % of the population prescribed drugs for anxiety, depression or psychosis than the average generally across South Ayrshire. The prevalence of diabetes in the Locality is above the South Ayrshire average.


Statistics for crime in this Locality present positively when compared against average figures for South Ayrshire as a whole, other than in Girvan where figures are above average.

Notes: 1. Based on 2011 Census data. 2. Based on National Records of Scotland 2011 Mid Year Population Estimate. 3. Based on Scottish Government SIMD 2012, Office for National Statistics 2012 Q04 via SNS and Department for Work

and Pensions 2012 Q04 via SNS. 4. Based on National Records of Scotland 1994-98 to 2003-07 via CHP Profiles 2010 - 5 year combined number, 5 year

average annual measure. 5. Based on National Records of Scotland 2007-09 via CHP Profiles 2010. 6. Based on Information Services Division Scotland 2011 via SNS. 7. Based on Information Services Division Scotland 1997-99 to 2007-09 via CHP Profiles 2010 - 3 year combined number, 3

year average annual measure and on Information Services Division 2011 via SNS. 8. Based on Snapshot 26/03/10 Scottish Care Information - Diabetes Collaboration via CHP Profiles 2010 and National

Records of Scotland 2006-08 via CHP Profiles 2010. 9. Based on Scottish Government, SIMD 2009 via CHP Profiles 2010 and (Scottish Prison Service 30 June 2008 via CHP

Profiles 2010.

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Appendix 8

Planning LevelsCharacteristics Functions

•Informed-local knowledge•Flexible•Bottom Up•Inclusive

•Representative•Locally responsive•Empowered•Volunteerism•Locally led & organised

•Cluster of neighbourhoods•Neighbourhood representation

•Working Group of Partnership•Clinical & Care Professionals Engaged•Structured, managed & supported

•Compliant•Structured •Robust Processes•Leadership•Responsibility•Accountability•Governance•Oversight

•Planning for small populations at neighbourhood level based in part around local knowledge

•Emphasis on owning and addressing local issues•Co-production, asset-based approach•Some devolved resources: e.g. small group fund to

incentivise community work and support local activity

•Prioritise Neighbourhood Actions inc. inequalities•Formalisation of professional and clinical input

•Oversight of local service delivery•Review progress against outcomes

•Strategic Planning•Overall Co-ordination•Overview on Inequalities•Emphasis on Population

Groups•Strategic Linkage to CPP•Strategic Linkage to Acute•Strategic Linkage - Pan-Ayrshire•Strategic Linkage – National

ServicesNational Outcomes

Locality Locality Planning

Locality

Locality Localit

y

Locality

Locality

Locality

Health & Social Care Partnership

Partnership Board

Partnership Stakeholder

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