HSCP Budget Consultation 2025/26

Residents, workers and organisations are being invited to help shape the future of services delivered by East Dunbartonshire Health and Social Care Partnership (HSCP).

Consultation is being held to help inform the HSCP’s budget-setting process for 2025/26 – have a say between 25 November and 20 December 2024.

The HSCP is responsible for delivering community healthcare, social work and social care services to residents in East Dunbartonshire.

The HSCP also hosts two health board-wide services on behalf of NHS Greater Glasgow and Clyde – Specialist Children’s Services and the Public Dental Service/Primary Care Oral Health.

The HSCP undertakes professional assessment of needs and care planning to support access to social care services and health interventions.

The HSCP directly or indirectly provides services which include:

• Social Work Children & Family Services and Universal Child Health Services
• Community and prison-based criminal justice services
• Care at Home/home care
• Care homes/residential care
• Independent living and social support
• District nursing
• Rehabilitation
• Child, adult and public protection
• Community occupational therapy, equipment and adaptations
• Drugs & alcohol recovery and mental health services
• Prescribing of medicines through GPs and other registered prescribers.

The HSCP also has responsibility for unplanned hospital care and reducing the amount of time people spend within a hospital setting when this is not the best place for them.

The proportion of expenditure on health, social work and social care services is set out here:

The largest areas of spend for the HSCP relate to staffing costs, payments to care providers for direct service provision and prescribing.

The work of the HSCP, and the delivery of services to people, is funded by contributions from NHS Greater Glasgow & Clyde and East Dunbartonshire Council. Funding also comes directly from the Scottish Government for specific priorities such as increasing the Scottish Living Wage paid to staff in the independent sector, increasing free personal and nursing care allowances, and support to carers.

In addition, the HSCP relies on income from directly charging services users for the services it delivers – generating around £1.8 million to support and maintain frontline services. The HSCP is restricted in what it can charge for.

As with other public sector organisations, the HSCP is under extreme financial pressures. These include uplifts in pay, increases in contractual payments for care services purchased from independent care providers, the cost of medicines, and rising demand for services due to increased volume and complexity of needs as people grow older or need support as regards mental health, addiction or being kept safe from harm. This is all occurring against a backdrop of real-term reductions in funding.

Projected savings require to be made by the HSCP of between £7.6 million and £13.3 million each year from 2024/25 onwards.

It will be necessary to consider options for service reduction and cessation, as the Integration Joint Board (IJB) – which manages the HSCP – cannot continue to deliver the current range or level of services.

The HSCP is required to set a balanced budget each year, with the IJB expected to determine the budget for 2025/26 in March 2025. We want to hear your views.

You can have a say by filling in our online survey below – between 25 November and 20 December 2024.

We recognise that to make the scale of savings required to deliver a balanced budget we need to fundamentally rethink how and what we deliver, and be honest that we will not be able to continue to deliver the same level or range of services.

To be sustainable, we need to move away from traditional service models based on distinguishing people by condition or age, or focusing on a deficit model predicated on demand.

Instead we want to move to ‘whole person’ and community approaches.

We recognise that some of the greatest improvements in many people’s health and wellbeing will come as a result of what they do for themselves.

By preventing unnecessary ill health, we can live longer, be happier and experience fewer complications in later life.

It is therefore important that we continue to recognise and build on the capacity of individuals and in communities – to take forward the prevention, early-intervention and self-management agenda, minimising unnecessary formal service activity for both individuals and staff, and making the most efficient use of the resources we have.

The IJB has approved a new strategic direction of travel, and a set of principles to guide our financial planning and how we do our business:

What we do

• Prevention and self help – empowering people and community-led support
• Early intervention and direct access to support – self management
• Structured service delivery based on assessment-led care planning and delivered at home or in a community setting
• Structured service delivery based on assessment-led care planning and delivered in a different setting
• Urgent, emergency and public protection-led and focused services.

How we do it

• Sustainable transformation
• Risk-enabled professional practice
• Mixed-skill workforce
• Digitally enabled/digital first
• Values-based health and care collaboration
• Self-directed care and support.

Fewer very specialist/focused services and teams, in favour of more generic ways of working to support the whole person, families and communities

Empowerment of individuals and communities – striking a new relationship that puts more power in the hands of patients and service users, and emphasises ‘working with’ rather than ‘doing to’

Prevention and self help – at an early stage and at the lowest levels of need. The focus is on connecting people with each other and their communities, and supporting them to be self-managing. People will be empowered to support themselves with access to information, advice and informal resources to enable them without formal service intervention.

Rehabilitation/re-ablement approach – focus on providing a high-quality first contact and assessment, guided by one or more professionals, passing through ‘gateway services’ focused on supporting people to regain and/or sustain their optimum level

Urgent, emergency and public protection-led and focused services are always accessed through qualified professional assessment and risk management-based planning. They may apply to people already in touch with services at any point in the spectrum of service delivery or people who have no current service input. These services are targeted at those in the highest levels of need, in line with statutory obligations and duties.

• Maximise income from charging for services to protect the delivery of frontline services, ensuring that only individuals who have the means should pay more for the services they receive directly
• Manage within available budget limits, meaning operating within affordable levels of service in the context of increasing demands on health and social care services
• Maximise efficiencies in the way services are delivered through a structured service review process – e.g. business support/administration support, use of fleet vehicles, reduced printing, mailing and file storage, etc.
• Maximise efficiencies through the review of contracting arrangements with commissioned service providers
• Redesign to deliver services within a reduced cost envelope and reduced levels of staff – e.g. occupational therapy, children & families and adult social work services, Family Support Team, etc
• Review and redesign of service delivery models across mental health and alcohol & drug recovery services, learning disability services and the voluntary sector
• Scope options for shared service delivery across other HSCP/local authority areas
• Values-based health and care – based on finding out what most matters to the individual, and helping to deliver care that will make a difference and improve prescribing practices – eradicating effort that provides no benefit for the person
• Tighten the eligibility criteria for targeted services to prioritise delivery of services to those with the highest levels of need
• A focus on prevention and ensuring individuals have more control to manage their own health and wellbeing needs to promote independence, with the understanding that the benefits of this approach are longer term and difficult to evidence
• Improve services through digital innovation and maximise the use of digitally-enabled care technology, where appropriate.