Care and wellbeing portfolio: newsletters

In this newsletter:

• latest developments -summary of Care and Wellbeing Portfolio Board - 24 January
• communicating with our Stakeholders - Preventative and Proactive Care Autumn event - engaging with local community organisations to policy development, Getting it Right for Everyone 
• portfolio delivery - Anchor Institutions update, Waiting Well Hub Launch
• linking Care and Wellbeing to NHSScotland delivery planning for 2024/25
• the Care and Wellbeing Dashboard

Latest developments: Care and Wellbeing Portfolio Board 24 January 2024

The strategic development of the Care and Wellbeing Portfolio (CWP) continues to progress with ongoing discussions on delivering commitments to long term health and care service reform and improving population health alongside how we improve short- and medium-term sustainability of the health and care system. Further engagement is being planned to look at how we can work together to shape and develop this approach moving forward. 

The Care and Wellbeing Portfolio Board met on the 24 January and discussed updates on progress across all programmes and enablers.

On Preventative and Proactive Care (PPC), work continues to progress at pace across its workstreams. Waiting Well materials are being shared with GPs, the Getting it Right for Everyone workstream has eight pathfinder teams working on prototyping, Primary Care PPC is progressing with four demonstrator sites for implementing MDTs and a new workstream on early detection and treatment of cardiovascular disease launched in January. 

Under the place and wellbeing programme work to create the Population Health Plan is continuing at pace, with the current focus being on initial engagement with key partners and ministers. National action is ongoing while the Population Health Plan is being developed, with key milestones in the next eight weeks looking at regulation on the food environment, minimum unit pricing for alcohol, and a four nations approach (on tobacco and vaping) to create a smoke free UK. The Anchors Workstream has asked for a baseline of activity from health boards by the end of March and will meet with each board to discuss plans; capacity issues have been identified and are being worked through by the Land and Assets group; Enabling Local Change has agreed a workplan to focus on strengthening health contribution and support to CPPs; local engagement with community and voluntary sector is progressing within the community workstream. 

An update on the National Strategy for Economic Transformation (NSET) was shared, which will receive a refresh due to changes in the fiscal environment, economic cost of living crisis, and a new First Minister to focus on a fairer, greener, and growing economy. 

The portfolio board was also updated on work needed in the short term to create a path to balance and long-term service sustainability and the programme work being scoped to take that forward. Further discussion along with proposals for how this impacts on the scope and governance will be taken to the next meeting on 23 April.

Communicating with our stakeholders

Preventative and proactive care autumn event 

On 24 October 2023, 196 attendees from across Scottish Government, health and social care and third sector organisations in Scotland attended the PPC event. The session gave an update on progress across the PPC workstreams since the Programme launch event on 26 October 2022, and touched on next steps including an introduction to the new Cardiovascular Disease (CVD) workstream. This CVD workstream will look to improve the early identification and management of key clinical risk factors for cardiovascular disease (high blood pressure, high cholesterol, average blood sugar, obesity), focusing efforts on those most at risk and who have been underserved by existing models, and supporting services to better manage identified risk factors via an individualised, evidence-based, and inequalities-informed approach to improve healthy life expectancy. A recording of the event is available to watch for those with an NHS Scotland email, and those with an email address external to NHS Scotland. 

Please get in touch with us at nss.ppc@nhs.scot if you have any issues accessing the recording, and we would welcome hearing from anyone with an interest in becoming involved with the PPC programme.

Engaging with local community organisations to inform policy development 

The place and wellbeing programme team recently commissioned three third sector interfaces to engage with community organisations in Arran and North Ayrshire, Inverclyde, and Midlothian. The purpose of this engagement was to provide an opportunity for community organisations to influence wider Scottish Government policies that impact on health and wellbeing. 

The engagement focused on the following themes: 

• influence - the voice of local community organisations in the decisions that impact on people’s health and wellbeing
• capability - effective sharing of data, evidence and expertise between community organisations and the wider public health system
• land and assets - community demand for use and/or transfer of NHS property

The findings of the local engagement exercise were discussed by the Communities Core Group and various internal and external stakeholders who have a direct policy interest at a workshop on 14 December.

Throughout the first half of 2024, the core group and programme team will sense-check the findings with a wider range of organisations and address any gaps in perspective that exist due to the three local contexts selected. The team will also work with Scottish Government policy leads and others to ensure that the recommendations that develop from these engagement approaches can be progressed through wider policy development, including the review of the Community Empowerment Act, and public sector reform, including Democracy Matters 2. 

A summary of findings will be available in early 2024 and a full report with recommendations and plan for implementation under each theme will be completed in the summer. As recommended by the National Standards for Community Engagement, we have also committed to meeting with the participants of the local engagement to discuss how their views have fed into policy development. 

Getting It Right For Everyone (GIRFE)

The Getting It Right For Everyone (GIRFE) team have met with health board, local authority and Health and Social Care Partnership executive and professional leaders in Dumfries and Galloway, Grampian, Lanarkshire and Ayrshire and Arran to discuss creating the conditions for GIRFE, challenges, opportunities and next steps. This follows the GIRFE pathfinders having submitted their ideas and concepts into the GIRFE process in mid-October, with an in-person sensemaking day having taken place in Dundee in November. 

This was an opportunity for pathfinders to discuss all the ideas and themes coming out of their recent engagements with people with lived experience. GIRFE pathfinders have been engaging with people with lived experience throughout the co-design process, with recent engagement focusing on ideation and concept-design. These ideas and concepts are going through a sense-making process, before prototypes are developed. 

The GIRFE team have also been engaging policy colleagues and professional advisors within Scottish Government to run ‘ideation sessions’, as part of the ideation phase of the GIRFE project. 

GIRFE has also been running partner recruitment days and nine Health and Social Care Partnership teams attended these sessions to learn more about GIRFE, get ready for next steps, and to consider an application to become a GIRFE Partner. Three Health and Social Care Partnerships applied to become GIRFE partners, and they will attend four onboarding sessions over the coming months. They will be working with pathfinders to design and/or test GIRFE prototypes on the theme of ‘The Team Around The Person’ from January to June 2024. 

The GIRFE team are recording a second information video in February, in collaboration with the Health and Social Care Alliance, which will feature pathfinder team members and people with lived experience. This will be available shortly.

Portfolio delivery - Anchor institutions update 

As part of the guidance for Annual Delivery Plans issued by the Scottish Government all NHS boards were asked to: set out their approach to developing an Anchor Strategic Plan by October 2023 which sets out governance and partnership arrangements to progress anchor activity; current and planned anchor activity and a clear baseline in relation to workforce; local procurement; and use or disposal of land and assets for the benefit of the community. 

NHS Boards have now submitted their Anchor Strategic Plans, and as anticipated, the plans reflected the very different stages that boards are at in terms of planning and progressing their anchor activity. Following an initial assessment by the Place and Wellbeing Team of the Anchor Strategic Plans, a further review has been undertaken by Public Health Scotland and Scottish Government workforce colleagues to ensure a fair assessment and to identify any areas for further support. 

NHS boards will soon receive feedback on their plans and Public Health Scotland will facilitate the sharing of Boards’ plans alongside existing and planned good practice through the Anchors Peer Learning Network. 

In addition, Public Health Scotland is leading implementing the communications strategy for the Anchors workstream including regular updates to stakeholders and the creation of a set of assets; a number of resources and case studies are already available on the Anchor webpages.

Waiting Well Hub launch 

The Waiting Well Hub launched on NHS Inform in late October 2023, designed to help people who may be waiting to see a healthcare specialist or to access health and social care services. The hub aims to provide access to better information to support people to proactively manage their health and wellbeing while waiting, to think about what matters to them and what health improvements they could make during this time. We encourage signposting to the site at the start of a person’s waiting journey and invite you to share with any colleagues and networks you think may have an interest. 

This is the first phase in the development of tools and guidance, with the Waiting Well workstream as a whole focusing on: 

• providing better information on how to wait well, including more self-help material on NHS Inform and signposting to local and national services
• supporting people to have a health and wellbeing plan for the active waiting time
• improving our systems to help people be able to find out more information about where they are on waiting lists

Using a dashboard developed by NHS24, we will capture site usage and statistics to inform future content improvements and design, and determine what information is most useful to end users. As of mid-January, a total of 9,494 users are reported to have viewed the Waiting Well hub pages 10,806 times.

Waiting Well will continue to promote awareness of the site and accompanying physical resources are in development including patient information leaflets and posters designed to support those not able to access the information digitally. A series of video packages with information from clinicians for patients to help support their pre-referral choice developed with the national Centre for Sustainable Delivery (CfSD) is also planned. Our thanks go to all who have contributed to the creation of these resources, which includes support from patient advisory groups who contributed towards content and provided valuable feedback.

Linking care and wellbeing to NHSScotland delivery planning for 2024 -2025 

We continue to see growing coherence across the system with the aims and priorities of the care and wellbeing portfolio. For instance, health board colleagues will be aware of the 2024 -2025 NHS Scotland Delivery Planning Guidance for NHS boards issued on 4 December 2023. This guidance builds upon the planning priorities set out in 2023/24 guidance, which included board actions to progress deliverables in the Place and Wellbeing and Preventative and Proactive Care Programmes, and the effective planning already underway by boards for 2024 -2025 through their medium-term plans. 

ThepPortfolio activities reflected within the 2023/24 NHSScotland Delivery Plan guidance included actions for Boards to become exemplar anchor institutions, exploring the potential of the Getting It Right For Everyone (GIRFE) multi-agency approach, expanding and enhancing ways of working through multi-disciplinary teams (MDTs), ongoing development of Community Treatment and Care (CTAC) services, shifting more care to primary care settings (e.g., Community Glaucoma Service), and further support for those waiting for health and social care interventions. 

In the 2024 -2025 guidance, we were encouraged to see an expansion of care and wellbeing portfolio related activities to include actions for boards to describe their current and planned commitments and contributions to Community Planning Partnerships (CPPs) to improve local outcomes and address the wider determinants of health, to improve their early detection and management of key cardiovascular disease risk factors, as well as a continued focus on digital reform and innovations as part of the Innovation Design Authority (IDA) and the Accelerated National Innovation Adoption (ANIA) pathway. 

A positive development in the recent guidance was the expansion of the "Health Inequalities" driver to more explicitly cover a wider range of population health planning and a new “Women and Children’s Health” driver being added. Further actions were also added in the cross-government space focused on responding to the climate emergency through adaptation and resilience measures, addressing child poverty locally and an increased focus on improving outcomes in the early years. The sustained and growing alignment to care and wellbeing portfolio activities demonstrates the positive influence the portfolio is continuing to have.

The care and wellbeing profiles on ScotPHO 

The October edition of the newsletter highlighted the newly created care and wellbeing dashboard, which provides the latest population health evidence base to support the care and wellbeing portfolio. 

In response to user feedback, we have decided to integrate the dashboard into the Scottish Public Health Observatory (ScotPHO)’s Online Profiles Tool. The ScotPHO platform already reaches a wide existing user base and has a strong focus on health inequalities, allowing the care and wellbeing indicators to appear within a single public repository of public health intelligence. 

A care and wellbeing profile view has been created within ScotPHO, providing an overview of the existing care and wellbeing indicators on the platform, including the option to view trend and deprivation inequality information where available. This aims to provide access to a range of evidence for health boards and local authorities and is structured around the evidence-based Marmot framework which looks at the wider social determinants of health. This is intended to support help: 

• understand progress against high level indicators at national and local level and monitor if outcomes are improving
• support improvement and drive change by delivery partners, including work by the Scottish Government, health boards, Community Planning Partnerships and others

Analysts are currently working to add data for the full suite of care and wellbeing indicators and are also in the process of establishing a ScotPHO User group that will meet online to discuss planned developments to ensure they are focused to meet user needs.

Useful links

Care and Wellbeing Portfolio Board minutes.

Previous editions of this newsletter 

• December 2022
• May 2023 
• October 2023

Get in touch

Please get in touch with the team if you would like to find out more about the care and wellbeing portfolio NSS.CareAndWellbeing@nhs.scot.