National Islands Plan Annual Report 2022

Health, Social Care and Wellbeing

Strategic Objective 7 – To improve and promote health, social care and wellbeing

We committed to work with NHS Boards, Local Authorities and Health and Social Care Partnerships to ensure that there is fair accessible health and social care for those on islands.

Implementation Route Map action

All of Scotland's islands are attached to Integration Authorities which serve the specific needs of those island communities. Integration Joint Boards will continue to work closely with Health and Social Care Partnerships to ensure each island is recognised within their unique circumstances.

Work is ongoing in relation to this commitment.

All the islands are attached to Integration Authorities which serve the specific needs of those island communities. Integration Joint Boards continue to work closely with Health and Social Care Partnerships (HSCP) to ensure each island is recognised within their unique circumstances.

The Primary Care Division of Scottish Government continues to engage regularly with Health Boards and HSCPs regarding the implementation of the 2018 GP Contract and wider issues. The Scottish Government has also allocated £600,000 to support Rural Relocation expenses, and fund Golden Hellos as set out in the Statement of Financial Entitlement. These initiatives will help address workforce challenges across remote, rural and island general practice.

'Rediscover the Joy of General Practice' is a collaborative project which provides the opportunity for GPs to work in different areas of Scotland and is co-ordinated from the central hub based in NHS Shetland. For 2022/23, the Scottish Government is allocating £198,000 to NHS Shetland which will allow for 249 weeks of GP cover for supporting practises.

The GP Contract is a substantial reform programme that requires some services to be delivered differently. In some cases, these will be moved out of general practice into community settings and the primary care workforce will adopt expanded and enhanced roles. The three Island Health Boards are supported in the change management process through the GP Change Management fund, which provided £117,252 in 2022/23.

Recognising the different skills requirement in island and rural Primary Care, £24,000 of funding was provided in 2022/23 to a Perthshire based charity BASICS which provides training in prehospital emergency care for health professionals practising in rural and island areas. The Scottish Government has also reported following a deep dive on dispensing practises and future projects.

The second year of the National Drugs Mission was focused on implementation and delivery with the National Drugs Mission Plan: 2022-2026 setting out the framework for delivery for the remainder of the mission and the outcomes we want to achieve, followed by the National Mission on Drugs: annual report 2021 to 2022. The Scottish Alcohol and Drug Partnership (ADP) annual survey provides information on the activity undertaken by each Alcohol and Drug Partnership (ADP) and evidences the progress of the National Mission.

The commitment to provide £250 million of additional funding over the lifetime of this Parliament to reduce the number of drug-related deaths in Scotland and improve lives has continued and gone directly to local areas via local Alcohol and Drug Partnerships. Island Boards have received approximately £1.7 million of this investment^[1], including implementation of the Medication-Assisted Treatment (MAT) Standards^[2], Residential Rehabilitation^[3] and Lived and Living Experience panels.

The Corra Foundation administer funds on behalf of the Scottish Government to support the National Drugs Mission. Local organisations can also apply to the Local Support Fund, Local Support Fund Micro Grants, Improvement Fund, or Children and Families Fund. Three projects in the Islands received funding totalling £175,000 in 2022/23.

We committed to identify and promote good practice, especially as regards the improvement of services in islands and other remote areas.

Implementation Route Map action

We will continue to implement the recommendations from the 'Shaping the Future Together: Remote and Rural General Practice Working Group' report.

Work is ongoing in relation to this commitment.

Island-based Integration Authorities and Integration Joint Boards continue to work closely with island communities to ensure each islands unique circumstances and specific needs are being met. Islands Integration Authorities are represented on the Strategic Planning and Performance Officers Group (SPPOG), the Chief Officers' Network for sharing good practice. There are also regular updates with Scottish Government, the Cabinet Secretary for Health and Social Care and the Minister for Mental Wellbeing and Social Care. Work is now underway to review progress against the recommendations from the 'Shaping the Future Together: Remote and Rural General Practice Working Group' report and establish the remaining priorities.

NHS Education for Scotland (NES) host the Remote and Rural Healthcare Educational Alliance (RRHEAL) which coordinates healthcare education, development and training for all the remote, rural and island areas of Scotland.

For 2022/23 The Scottish Government is allocating £176,000 to NHS Highland to support the Scottish Rural Medicine Collaborative which is funded to develop ways to improve the recruitment and retention of people working in Primary Care.

To ensure access to breaks from caring in practice, including overcoming unique barriers in island communities, the Scottish Government provides a Short Breaks Fund. The fund was £3 million per year up to 2021-22 and has been increased by £5 million in 2022-23 to expand easy-access short breaks support. Under this fund, the Time To Live and Take a Break Scotland grants, and the Creative Break and Better Break projects are delivered. In addition to the Short Break Fund, the Promoting Variety in Short Breaks project, run by Shared Care Scotland and Health Improvement Scotland, helps local authorities and integration authorities meet their responsibility to promote availability of different short break support services in their areas. These grants and projects take into consideration the additional costs of providing breaks to carers in rural and island communities and are designed to ensure the flexibility and creativity necessary are in place to ensure access to breaks from caring.

We committed to support the extension of NHS Near Me, and other digital health initiatives, to reduce unnecessary travel and enable more care to be delivered on Islands.

Implementation Route Map action

• NHS Near Me has been implemented and is being utilised across every Health Board in Scotland with upwards of £1.3 million appointments undertaken using the platform since early 2020. This continues to provide greater flexibility, whilst supporting remote working, reducing the need to travel and promoting greater access to specialist services. We also continue to support people to manage their condition from home with new digital platforms established for things like blood pressure and Covid-19 monitoring being rolled out across the country. This project is a first step in understanding how we create our own services which can be tailored to meet the needs of the Scottish population.
• Procurement of a 'once for Scotland' digital solution for the education and management of type 2 diabetes is being considered.
• Scottish Government Digital Transformation Service (DTS) will undertake a research and service design project into type 2 diabetes and weight management services which will identify patient needs, the gaps in current services and how these can be addressed.

Work is ongoing in relation to this commitment.

The use of digital continues to be a key priority to support better choice and access to health and care services. The Near Me video consultation service has now supported more than 1.8 million people through appointments since early 2020 across Scotland, avoiding over sixty million miles of unnecessary travel with important benefit for those on Island's and rural areas. Remote monitoring of conditions is also being prioritised with over 40,000 people now having monitored their blood pressure from home through our Connect Me service with further developments for other conditions underway. Digital for Mental Health has seen significant growth with a range of self-help guides, self-referral therapy and self-management options now available to the public. Scotland's Digital Health and Care Strategy (2021) and supporting delivery plan set out the approach to continue to support people with digital services options to complement existing service delivery.

We committed to work with stakeholders to develop propositions for a national centre for excellence in remote, rural and island health and social care.

Implementation Route Map action

In the 2022 Programme for Government, we have committed to ensuring that our islands and rural areas are not left behind as we work to improve health services by creating a centre of excellence for rural and remote medicine and social care, with scoping work starting this year. We will continue to scope and engage with stakeholders.

Work is ongoing in relation to this commitment.

The Centre is anticipated to be established in 2023 and will measurably improve the sustainability, capacity and capability of the remote, rural and island Primary Care and community-based workforce and the vital services they deliver to support people living in Scotland.

We committed to work with stakeholders to ensure that we develop a plan to adequately support the ageing population of island communities so that they remain active, connected, engaged and have access to suitable, quality opportunities.

Implementation Route Map action

Integration Authorities will continue to work closely with their communities to develop strategic plans for delivery of health and social care services most suitable to the specific needs of their communities.

Work is ongoing in relation to this commitment.

Integration Authorities have continued to work closely with their communities to develop strategic plans for the delivery of health and social care services most suitable to the specific needs of their communities.

We committed to support relevant local authorities to plan and develop sports facilities on the islands that respond to the needs of communities.

Implementation Route Map action

• sportscotland will continue to engage strategically with local authorities (through their capital planning processes) and Islands communities with regards to opportunities to deliver improved local facility provision for sport and physical activity.
• sportscotland and the Islands team are continuing to have discussions with Orkney Islands Council regarding strategic facilities investment that would deliver improved local facility provision in preparation for the 2025 Orkney Island Games and beyond.

Work is ongoing in relation to this commitment.

We continue to work with colleagues in sportscotland who engage strategically with local authorities (through their capital planning processes) and island communities with regards to opportunities to deliver improved local facility provision for sport and physical activity.

In August 2022, sportscotland made an award of £190,470 to Arran High School Mountain Bike Club via its Cycling Facilities Fund. The investment will be used to develop a community cycling hub comprising bike trails, a pump track and a hub building. The new hub will be open to the community for free use throughout the year and will be suitable for all levels of participants with dedicated coaching available. The Club will also set up its own bike station and maintenance facilities to provide further education opportunities for young leaders to gain knowledge in maintenance and coaching. Already recognised by Scottish Cycling as a notable example of a school cycling club, the new development at Arran High School has the potential to have a huge impact on cycling participation in the local area.

In November 2022, sportscotland made an award of £61,124 to Tong Recreation Association via its Sport Facilities Fund. The investment will be used to construct a new and modern skatepark on the Isle of Lewis. Within travel distance from Stornoway, the nearest large town on the island, the skatepark will provide an alternative sport opportunity for those who do not see themselves participating in traditional sports such as football, rugby and athletics on offer across the island. It is hoped that that this new facility will encourage more active lifestyles, improve mental well-being and create a connection across generations in the community. There is a commitment to provide targeted opportunities for woman and girls (an area of high growth in the sport) to take part through organised events and sessions. This new facility and targeted opportunities will hopefully help support a reduction in rural inequalities.

sportscotland is also currently engaged in conversations with Argyll & Bute Council on further facility development, as part of the Sports Facilities Fund, which will potentially see applications for investment into Island communities. These conversations have already resulted in sportscotland awarding £17,600 to the Isle of Seil Golf Club in August 2022 to purchase the golf course. The award will preserve the main sporting facility on the island as it was under threat from sale by the landlord. The preservation of the golf course will also allow existing water sports to develop a base on the island and utilise the land owned by the club for a launching point.

We committed to promote participation in sport and physical activity by ensuring national programmes such as Active Schools and Community Sports Hubs are serving island communities and continuing the Islands Athlete Travel Award Scheme.

Commitment Fulfilled

This commitment was fulfilled in 2020. Please see the National Islands Plan Annual Report 2020 for further details.

We committed to work with Orkney Islands Council and other partners to use the hosting of the 2023 Islands Games by Orkney to strengthen sports development on the island.

Implementation Route Map action

• sportscotland will continue to support Orkney Islands Council, Orkney Islands Organising Committee and local sports associations to add value to Orkney hosting the (rescheduled) 2025 International Island Games through the development of the local infrastructure of people, places and pathway opportunities.
• sportscotland will continue work with the Community Sport Hub Officer and with the Orkney Islands Games Organising Committee to deliver a needs-based programme of education and development for coaches and volunteers.

Work is ongoing in relation to this commitment.

sportscotland partnered with the Orkney Island Games Organising Committee and Orkney Islands Council to deliver a Planning Weekend at Glenmore Lodge, in September 2022, with ten (of the thirteen) Sports Governing Bodies (SGBs) that will be involved in the Orkney 2025 Games. The weekend was also supported by Serco North link Ferries and Stagecoach, who provided transport to Orkney based delegates to Aviemore. A key aim of the event was to connect SGBs with their respective clubs responsible for organising their sports' events within the Games.

The weekend agenda focused on the construction and development of detailed plans to ensure Orkney have the key elements in place to deliver the Games. This included the right facility infrastructure, well trained people and volunteers and coaches and athletes, who will not only contribute to a successful Games but will also inspire and provide a sustainable infrastructure for the people of Orkney to thrive and lead active lives in the future. The weekend successfully concluded with clubs having created stronger relationships with their respective SGBs, detailed plans in place, as well as support networks established and strengthened.

sportscotland also supported the development of the Physical Activity and Wellbeing Strategy for Orkney, which is aligned to local and community priorities. The strong process of stakeholder engagement has been chaired by an elected member with input from key partners including Orkney Islands Council, NHS Orkney Pickaquoy Trust, Inclusive Orkney, and other third sector organisations. The Strategy launch was delayed due to staffing challenges and the Council election; however, it is due to launch in the early part of 2023 through the Community Planning Partnership.

We committed to work with our partners to eliminate unlawful discrimination, harassment and victimisation and take steps to assist with promoting equality and meeting people's different needs.

Implementation Route Map action

• As highlighted in A Fairer, Greener Scotland: Programme for Government 2021‑22, we aim to ensure that all eligible children who are victims or witnesses to abuse or violence will have access to a 'Bairns' Hoose' by 2025. That means the services they need will all be available via a coordinated approach designed to reduce the number of times children have to recount their experiences to different professionals. Children below the age of criminal responsibility, whose behaviour has caused harm, will also have access to the services it will provide. Bairns' Hoose – based on an Icelandic model 'Barnahus' – will bring together services in a 'four rooms' approach with child protection, health, justice and recovery services all made available in one setting. A new National Bairns' Hoose Governance group is currently being established and will consider issues around implementation in rural and island settings.
• The new Scottish Child Interview Model for Joint Investigative Interviews is being introduced nationally from 2021 to 2024 and will be seen as the 'justice room' of the Bairns' Hoose. The National JII Governance Group has established the Remote and Islands Joint Investigative Interviewing Implementation Subgroup in recognition that a particular focus on the implementation challenges in remote and island contexts will help realise our shared ambition that all children in Scotland have access to the Scottish Child Interview Model for joint investigative interviewing where this would best meet their needs.
• We will remain committed to investing in interventions which provide evidence of being able to change the attitudes of offenders. We will expand the availability of the Caledonian System. This is an internationally recognised behavioural change programme for perpetrators of domestic abuse which involves working with the whole family to reduce the risk of harm to women and children. We will progress work over the next two years to support the national rollout of the system, with the aim of making it available to all 32 Scottish local authorities by the end of the parliamentary term.

Work is ongoing in relation to this commitment.

We remain committed to investing in interventions which provide evidence of being able to change the attitudes of offenders. The Scottish Government and Community Justice Scotland are currently exploring practical options to safely and sustainably deliver the Caledonian System to the Islands. However, consideration must be given to the impacts of the COVID-19 pandemic on the operation of the Caledonian System, our ability to assess and evaluate during this period, and what lessons might be learned to further enhance the overall programme and ensure those areas already delivering the project are supported.

Bairns' Hoose

We have committed to improving the experience of Scotland's child protection, criminal justice and healthcare systems for children who have experienced trauma by ensuring that every child referred will have access to the services of a Bairns' Hoose.

• Over the last year, Scottish Government officials, in conjunction with the Chair of the National Bairns' Hoose Governance Group, have carried out extensive engagement with key partners from across children's services, health, justice, and the third sector. This includes Chief Officers' Public Protection Groups (COGs), who will play a key role in the delivery of Bairns' Hoose. We are developing a phased approach to the implementation of Bairns' Hoose across Scotland, with a Pathfinder phase beginning in spring of this year (2023). During this phase, national standards will be tested in multi-agency pathfinder sites. We will publish further information on our plans for delivery in the coming months, along with a progress report on our Bairns' Hoose Project Plan.
• While work on Bairns' Hoose progresses, we continue to make improvements to children's experiences in the justice system through the Scottish Child Interview Model for Joint Investigative Interviews, which is currently progressing with a three-year national rollout to the end of 2024. The Scottish Child Interview Model will be a cornerstone to the Bairns' Hoose approach to justice in Scotland. Ministers have agreed that overarching principles are essential, with flexibility for local delivery partners to adapt the model for their local context. This should be flexible enough to allow local authorities to tailor Barnahus to suit local circumstances. Close collaboration across agencies and between local partnerships is a prerequisite for development, implementation and evaluation of the approach. A working group has been established under the national governance group for joint investigative interviews to look at this issue for implementation of the Scottish Child Interview Model, applying the principles detailed in the Scottish Government published Island Communities Impact Assessments. We will take learning from their findings to apply in our development of a national Bairns' Hoose model.

Our Delivering Equally Safe fund is providing £19 million per year to 121 organisations to help implement Equally Safe, Scotland's strategy to prevent and eradicate all forms of violence against women and girls. A priority area of the fund is working with those in remote or island communities. We are funding ten organisations and partner agencies who provide services to Scotland's Island communities just under £3 million through the Delivering Equally Safe Fund. These organisations include Women's Aid Orkney, Western Isles Rape Crisis Centre, Shetland Rape Crisis and Argyll and Bute Violence Against Women and Girls Partnership.

We committed to address any equality, health and wellbeing related data gaps that exist in respect of, for example, women and girls, pregnancy and maternity, gender reassignment and sexual orientation.

Implementation Route Map action

• Scottish Women's Aid published the findings from their Participating-in-Equally-Safe-in-the-Highlands-and-Islands consultation. We will be working with partners on how to implement the recommendations following the report.
• A priority of the Delivering Equally Safe Fund is working with those in remote or island communities. The fund will run from October 2021 to September 2023.
• Additionally, the Scottish Government has committed to an independent strategic funding review to look at how national and local specialist services for women and children experiencing gender-based violence are commissioned and funded across Scotland, which will commence in 2022.

Work is ongoing in relation to this commitment.

The Review of the Funding and Commissioning of Violence Against Women and Girls (VAWG) Services was announced by the Cabinet Secretary for Social Justice, Housing and Local Government during the Scottish Parliament debate held on 25 November to mark the International Day for the Elimination of Violence Against Women and Girls. It will be chaired by Lesley Irving and will report by March 2023. The principal aim of the review is to develop a more consistent, coherent, collective and stable funding model that will ensure high quality, accessible specialist services across Scotland for women, children and young people experiencing any form of VAWG. Services for children and young people in their own right as victims will be included. The review will also include those services which recognise the vital role of prevention in increasing safety for women, children and young people.

Scottish Government's First Data Strategy for Health and Social Care was published on 22 February 2023. It sets out how we will work together in transforming the way that people access their own data to improve health and wellbeing; and how care is delivered through improvements to our systems.

We committed to consider our consultation on out of school care through which we have gathered views from parents on the challenges of accessing childcare and range of activities for school age children in island communities. Responses to our consultation will, together with continued engagement, inform development of a future strategic framework which will be published before the end of this parliamentary term.

Implementation Route Map action

We are currently developing potential rural childcare projects in island communities which aim to explore models of delivery that can provide the flexibility required by the local workforce, including women in agriculture.

Work is ongoing in relation to this commitment.

In 2020-22, we awarded the Mull and Iona Community Trust (MICT) £180,000 to develop and deliver school-age childcare services on Mull considering the flexibility that is required in island communities as well as utilising local partnerships and existing community resources. While many families benefitted from access to affordable childcare, the project found challenges with the availability, recruitment, and retention of suitably qualified workers. These challenges will be reflected in the Strategic Framework for Scotland's Childcare Professionals which will be published later this year.

The findings from the project and the recommendations made in the Accessing School-Age Childcare in Scotland's Rural and Island Areas research report will help support the development of new school age childcare policies. The research report complements the testing we are already carrying out through our Access to Childcare Fund, which has been supporting services across Scotland, including in rural areas, to deliver childcare for families on low incomes. We have built on the learning from the Access to Childcare Fund to develop community-level tests of change through our Early Adopting Communities programme, which will allow us to understand the systems needed to support a childcare offer that is locally appropriate.

Work is also currently underway with our People Panel, which is working across Scotland (including in remote and rural and island areas) to understand parents and carers needs from the future system of school-age childcare.

This year, we will publish a School-Age Childcare Delivery Framework which will set out the approach and principles that we will apply to designing and building a new system of school-age childcare. The Delivery Framework will be supported through an initial investment of £15 million in 2023-24. This will build on the investment we made in 2020-22 and 2022-23 to develop tests of change to provide targeted school-age childcare services before and after school, and throughout the summer holidays.

We are currently making decisions on the administration of this funding; however, it will continue to be targeted towards the six priority groups identified in the Best Start, Bright Futures: Tackling Child Poverty Delivery Plan, and will be spread across a diverse range of communities in Scotland.

We committed to ensure that health, social care and wellbeing services are available through the medium of Gaelic to support Gaelic speaking island communities.

Implementation Route Map action

• NHS Highland commitments to Gaelic are outlined in its Gaelic Language Plan, 2017-2022.
• NHS Western Isles is currently revising its Gaelic Language Plan and will submit it to Bòrd na Gàidhlig soon. NHS Western Isles commitments to Gaelic will also be set out in its Gaelic Plan when approved.

Work is ongoing in relation to this commitment.

Using Gaelic plans, Bòrd na Gàidhlig is continuing to work with health boards in island areas to encourage the use of Gaelic in the delivery of services and raise the profile of Gaelic in these communities. The Scottish Government welcomes the creation of Gaelic plans by health providers and looks forward to commitments that will make a difference where Gaelic is spoken.

We committed to align our ambition to eradicate child poverty with the Plan by continuing to work with island local authorities and health boards to build on their understanding of child poverty in their areas – helping to focus efforts on lifting families out of poverty and mitigating against its damaging impact.

Implementation Route Map action

• We published the second Tackling Child Poverty Delivery Plan in March 2022. The Plan outlines the transformational actions we will take alongside our delivery partners – including island local authorities and health boards – to deliver on our national mission to tackle child poverty.
• Island local authorities and health boards will continue to be required to produce Local Child Poverty Reports under the terms of the Child Poverty (Scotland) Act 2017, and the work with national partners set out below will continue to help to inform local action.

Work is ongoing in relation to this commitment.

In March 2022, we published our second Tackling Child Poverty Delivery plan – 'Best Start, Bright Futures' alongside an Island Communities Impact Assessment. The plan sets out ambitious action to drive progress to the child poverty targets and takes a holistic, person-centred approach to supporting children and families.

During 2022, the Scottish Government has continued to work with island local authorities, as part of the national Tackling Child Poverty Delivery Plan, to ensure successful delivery of key commitments. This includes delivery of 1,140 hours of funded Early Learning and Childcare and continued investment in parental employability support and free bus travel for under 22s. We also provided funding for Discretionary Housing Payments to provide direct financial support to people struggling with housing costs and to mitigate UK Government welfare policies.

Alongside action to support parental employment and reduce costs of living, key Scottish Government investment in social security is helping local areas to tackle poverty and enhance the support available for parents and families. This includes the Scottish Child Payment which, from 14 November 2022, was increased to £25 per week and applications were opened to all eligible 6-15 year olds. The payment is estimated to lift 50,000 children out of poverty in 2023/24.

Together with national partners, including the Improvement Service, Public Health Scotland and the Scottish Poverty and Inequality Research Unit, the Scottish Government have worked with island authorities and others to support development of Local Child Poverty Action Reports and development of effective action to tackle child poverty in our islands communities – where poverty can often be hidden in national level statistics due to the higher cost of living experienced.

Many of our rural and island communities face different challenges and barriers and have unique assets that can be brought to bear in tackling child poverty. We have commissioned research into rural and island child poverty and will act on the findings, taking targeted action to tackling child poverty in rural settings, focusing on unique solutions rooted in these communities. Furthermore, a Rural and Island Child Poverty Network has been convened by the Improvement Service, bringing together key professionals to help collate the evidence and enable us to tackle child poverty effectively in these communities. Future projects to emerge from this work will follow the pathfinder approach, supporting local actors to test different community-based solutions, building partnerships, improving data and monitoring of actions.

Future projects to emerge from the research will also align with the work being led by the Scottish Government's Tackling Child Poverty Unit and have strong synergies across four key COVID-19 Recovery themes:

• person centred services;
• creating good jobs;
• tackling poverty; and
• improving wellbeing of children and young people.

Collectively, and as part of a government-wide focus, our work on child poverty across rural communities and on our islands will support:

• the tackling child poverty delivery plan, 'Best Start, Bright Futures'(2022-2026);
• our Programme for Government commitments on child poverty;
• COVID-19 Recovery; and
• the identification of future interventions to tackle and child poverty.

Tackling Child Poverty – Rural and Island Activity

Tackling Child Poverty is a national mission for this government, and we are using all the powers and resources available to us to tackle poverty and help all those struggling to make ends meet. We know that there are particular and distinct challenges, barriers and opportunities for our rural and island communities.

It is therefore vital that we identify and deliver place-based solutions that mitigate the detrimental impacts of child poverty and help young people to navigate the challenges that they face. Our vision is to better understand the specific contextual difficulties for tackling child poverty in rural and island communities and to ensure that this understanding is embedded in the policies that are developed and delivered across Government and in our communities.

Island Cost Crisis Emergency Fund

The £1.4 million Islands Cost Crisis Emergency Fund was developed to support those on islands facing even more significant cost of living challenges. Islands already experience higher costs of living. High fuel costs, a colder climate and the lack of consumer choice is also intensifying the impact of the cost crisis. This fund was provided directly to island local authorities on a 100% population basis, as approved by COSLA, to support them to take urgent action to help households through the cost crisis. The criteria and reporting processes required are minimal to lessen the impact on the workloads of local authority colleagues. To respond to the specific needs of islands communities and acting in the spirit of the Islands (Scotland) Act 2018, the Island Cost Crisis Emergency Fund complimented action carried out by local authorities within their respective geographical areas.

Demand Responsive Transport (DRT)

ZetTrans and HITRANS have been supported in developing both a DRT study and the rollout of DRT software, respectively. In December, the Islands Team, HITRANS, and Comhairle nan Eilean Siar met to discuss how DRT can support the Comhairle's focus on addressing local priorities in Uist such as depopulation, social inclusion and tackling child poverty – which will inform next steps and decision-making on future policy development considerations.

We committed to work alongside national partners, continuing to share good practice identified across Scotland which could be applicable to child poverty in our island communities.

Implementation Route Map action

• We will continue to work with national partners to ensure knowledge and good practice is shared and to support and improve local responses to tackling child poverty, including in our island communities.
• The Scottish Government Islands Team committed to working closely with Child Poverty colleagues to adapt the wider measuring framework for island policy delivery – ensuring that evidence is robust and aligns with and forms part of the work and reporting being led by the Tackling Child Poverty Unit and led by the new Tackling Child Poverty Development Plan (March 2022).

Work is ongoing in relation to this commitment.

We continue to work closely with national partners, including the Improvement Service, Public Health Scotland and the Scottish Poverty and Inequality Research Unit, to support local island authorities and others in developing their Local Child Poverty Action Reports (LCPARs). This has included refreshing the non-statutory guidance on LCPARs in consultation with local leads, to ensure clear, focused reports which reflect the wealth planned and ongoing local action to tackle child poverty.

Building on the "Poverty in rural Scotland: evidence review" (December 2021), SRUC were commissioned to undertake the research project, "Improving our understanding of child poverty in rural and island Scotland" which was published in June 2022. We will act on the findings, alongside local experts, to deliver targeted action on child poverty. We are also supporting gathering existing data, identifying gaps, and sharing good practice through the Rural and Island Child Poverty Network convened by the Improvement Service. The Network brought together key professionals, including Public Health Scotland and colleagues from our Tackling Child Poverty Unit. This collaborative, cross-sectoral and outcome driven partnership accelerated our response to research, using existing child poverty action reports to support locally led interventions. Furthermore, in November 2022 IS published a solutions paper: 'A Design Based Approach to Understanding and Tackling Rural Child Poverty'.

Another important outcome from this work is our research into the 'Anchor Project' on Shetland. This work is deepening our understanding of this extraordinarily successful, multi-agency rural child poverty initiative. The Anchor Project wraps support from existing frontline services around the needs of families to directly tackle poverty and inequality, while avoiding the stigma sometimes associated with support provided through other services.

We committed to work with islanders to contribute, where we can, to the creation of a fairer, healthier, happier nation for all of Scotland by supporting the work of the group of Wellbeing Economy Governments (WEGo).

Implementation Route Map action

We continue to learn and collaborate with other countries and organisations to create an economy that supports our island communities, aiming to ensure that they have access to opportunities that deliver local growth and wellbeing through tackling inequalities.

Work is ongoing in relation to this commitment.

We continue to learn and collaborate with other organisations to create an economy that supports our island communities, aiming to ensure that they have access to opportunities that deliver local growth and wellbeing through tackling inequalities. The Community Wealth Building (CWB) model of economic development continues to act as a framework against which our local authorities can work with the private, third and community sectors to deliver a genuine, tangible wellbeing economy. The model is designed to add value and influence the activities of the landscape of partnerships we already have in place.

We committed to work with our partners to consider a range of options to ensure that adequate mental health care is available, whilst taking into consideration the uniqueness of our island communities.

Implementation Route Map action

• We have committed to reviewing the Mental Health Strategy 2012-2027 at its halfway point in 2022. Reviewing the Strategy also provides us with an opportunity to systematically review all our other existing commitments and make sure that our policies around rural mental health are current and appropriate for those living throughout rural and island areas in Scotland.
• We will continue to work with the National Rural Mental Health Forum to ensure to understand the emerging needs of island and rural communities around Covid-19 recovery and in particular to share community-based solutions to support good wellbeing. This will look at the role of place and future Community-Led Development opportunities to support resilience in our communities in partnership with others.

Work is ongoing in relation to this commitment.

We are committed to developing a new Mental Health and Wellbeing Strategy in the coming year, building on the implementation of our Mental Health Covid Transition and Recovery Plan. The new strategy will allow us to look ahead to make sure we are doing the right things to meet changing Mental Health needs over the coming years; and will set out a clear vision for future population mental health, wellbeing and care, and our priorities to help us get there.

We want to ensure that our future strategy is evidence based, informed by lived experience, and underpinned by equality and human rights. It will focus on outcomes and will be driven by data and intelligence. The scope of the strategy will be wider than our previous work in this space, with an increasing focus on wellbeing and prevention. We will also consider how the strategy can take account of social factors and inequalities that may impact a person's mental health and wellbeing.

We know that a cross-Government effort will be required to achieve this, and we will be working closely with colleagues across different portfolios, and relevant stakeholders to inform our approach to this important work.

Mental Health Performance in the Island Boards

We are committed to continuing to ensure that people get the right support, at the right time, and in the right setting. This means continuing to work and invest across sectors, and across community and acute settings, including for our island communities.

Scottish Government officials meet with Mental Health Leads in the Island Health Boards to review performance against mental health waiting times standards for Child and Adolescent Mental Health Services and Psychological Therapies. We recognise that although local performance varies, there are shared challenges for remote and rural boards. These include workforce recruitment and retention, as well as the impact of small teams which makes them more susceptible to staffing changes. The Scottish Government remains committed to supporting Island Boards' mental health services to develop their workforce, increase service provision and ensure that those who need care can receive it in a timely manner. In 2022-23, we are allocating funding of £46 million across Scotland via the 2022-23 Mental Health Outcomes Framework to improve the quality and delivery of mental health and psychological services for all. The priorities for the funding this year are to continue delivering improvements in CAMHS, psychological therapies, eating disorders and neurodevelopmental services, as well as ongoing innovation and service reform.

Our Transition and Recovery Plan recognised that there can be challenges relating to rural isolation, which may be increasingly felt by those in remote communities because of the pandemic. We have committed to working in partnership with the National Rural Mental Health Forum to develop an approach to ensure that these communities have equal and timely access to mental health support and services, including consideration of whether dedicated pathways are needed. We are keen to support efforts by NHS Boards to promote the use of digital services, to maximise the benefits for rural communities; whilst recognising that this is not the solution for everyone.

Communities Mental Health and Wellbeing Fund for Adults

The Communities Mental Health and Wellbeing Fund for adults – providing £36 million over two years – was launched by the Minister for Mental Wellbeing and Social Care in October 2021 to help tackle the impact of social isolation, loneliness and mental health inequalities made worse by the pandemic.

In 2021-22, £21 million was distributed to around 1,800 community projects in Scotland, highlighting the significant role that small, grass roots, community groups play in supporting adult mental health and wellbeing. This includes over £2.4 million to projects in areas covered by the National Islands Plan. For example, funding was provided to Argyll and Bute Cowal Elderly Befrienders, a service aimed at older men living at home in Cowal and Bute who are identified as being over sixty-five and at risk of loneliness and social isolation. Outreach Worker visits weekly and a working bond is established.

The funding supported 1,026 projects with a focus on social isolation and loneliness across Scotland and 468 projects with a focus on those disadvantaged by geographical location. For example, Bragar and Arnol Siorsa Project (Freedom Project) in the Western Isles aims to reduce social isolation for a targeted group of isolated individuals in a remote community. This project is being run by a community group who are using a befriending model.

Community-based Mental Health Support for Children and Young People

In addition to adult community mental health support, the Scottish Government provided local authorities with £15 million in 2022 to fund community-based mental health supports for children and young people and their families. These services are focused on prevention and early intervention and include supports for positive mental health and wellbeing as well as emotional distress. The funding gives councils the flexibility to implement supports based on local priorities such as an Emotional Wellbeing Service delivered by Action For Children in Orkney which focuses on early intervention for children and young people aged 8-18 in need of support. This links to the partnership drugs initiative, which is a whole-family approach intended to provide support to the young person affected by or misusing substances or alcohol. In Shetland, the local authority has commissioned Mind Your Head to provide a Well Youth children and young people's support service. This includes self-referral, drop-in, telephone support, and referral from other services.

National Rural Mental Health Forum,

The Scottish Government continues to fund the National Rural Mental Health Forum, which was established to help people in rural areas maintain good mental health and wellbeing. This forum helps develop connections between communities across rural Scotland, so that isolated people can receive support when and where they need it.

Mind to Mind

In May 2022 the Scottish Government announced the launch of Mind to Mind, a new site to support the mental wellbeing of the general population in Scotland, including in rural and island communities. Mind to Mind showcases advice from people with lived experience of mental health and wellbeing challenges and highlights the practical things people can do to help themselves regardless of where they live or work.

It has been designed to provide a reliable place for people to find information on mental wellbeing, complimenting traditional mental health and wellbeing services across Scotland. It is not meant to replace them. Importantly, Mind to Mind is hosted on NHS Inform which is a whitelisted site; visitors do not use their mobile or internet data when visiting the site. We will continue to further develop content on Mind to Mind and identify further resources for inclusion.

Primary Care

The Scottish Government provided £1.5 million in December 2021 to Island Authorities to support the development of local Mental Health in Primary Care Service implementation plans. These were developed at a local level, in collaboration with partners, throughout 2022 and submitted to the Scottish Government. Given the Emergency Budget Review we continue to collaborate closely with stakeholders, including the Mental Health in Primary Care National Oversight Group, to develop plans to best use the resource available across the system in 2023/24, and in future years. Nonetheless, Mental Health in Primary Care has been signalled within the Mental Health Outcomes Framework allocation this year. The aim is to signal that this remains a priority and to enable local flexibility.

We have also continued to prioritise significant investment to build mental health capacity in primary care through Action 15 and the Primary Care Improvement Fund. In March 2022: the Scottish Government's Action 15 commitment had seen an additional 356.1 WTE mental health workers recruited to GP practices; and 259.9 WTE mental health workers had been recruited under the Primary Care Improvement Fund (PCIF).

The PCIF also funds Community Link Workers (CLWs) as part of primary care multi-disciplinary teams (MDTs) and, in March 2022, 248.9 CLWs had been recruited to support GP practices.'