Integration Joint Board releases annual report for 2022-23

East Lothian’s Health and Social Care Integration Joint Board (IJB) is delighted to share its Annual Performance Report for 2022-23, demonstrating its ongoing commitment to developing and delivering services and innovative approaches to achieve positive health and wellbeing outcomes for East Lothian’s residents.

IJB Chair Shamin Akhtar comments, “Whilst the immediate threat from COVID has waned, the context within which health and social care services operate continues to be very challenging. 

“The progress documented in this annual report has only been possible due to the hard work and unwavering commitment of East Lothian’s staff and partners who have adapted, innovated, and responded to the many and varied challenges that have come their way. For this, on behalf of the IJB I wish to express, our extreme gratitude to everyone involved.”

“This report highlights inspiring initiatives, and examples of services going above and beyond to ensure positive outcomes for local residents.  There is much to be proud of, as East Lothian showcases once again, its commitment to be one of the leading health and social care partnerships in the country. “

Fiona Wilson, Chief Officer of East Lothian Health and Social Care Partnership (ELHSCP) adds, “As much as this report is retrospective, it clearly demonstrates the incredible achievements and unwavering dedication of partnership colleagues, to put the needs of East Lothian residents first and foremost; despite facing multiple challenges and adversity.  Our commitment to co-producing, innovating and developing our service areas to meet the needs and demands of our county’s residents is reflected throughout the report.

“2022/23 has shown us what is possible post-pandemic, and the newly developed IJB Strategic Plan provides a road map for our continued integration over the next three years, and our pledge to deliver the best health, best care and best value for East Lothian’s communities.”

Download the full 2022-23 IJB Annual Performance Report
 

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Annual Report Key Headlines 

Social work assessment waiting times 

A new operating model for Adult Social Work (introduced in 2021) continued to reduce the time people waited for a social work assessment in East Lothian. The model ensures that as many cases as possible are dealt with at the ‘first point of contact’, rather than people being added to a waiting list. By the end of 2022/23, this approach had reduced the waiting list for assessment to zero.
 

Reducing the pressure on hospital beds

East Lothian continues to perform very well in relation to ‘delayed discharge’. The number of days people aged 75+ spent in hospital when they were ready to be discharged was 206 (per 1,000 population). This compared favourably to the Scottish rate of 919 per 1,000 population). 

The introduction of a new ‘Daily Flow Huddle’ and ongoing development of the Integrated Care Allocation Team approach in East Lothian, continued to prove effective in bringing together different health and social care professionals to reduce the time people stayed in hospital once with they were clinically fit to go home.

An Inreach pilot project was launched involving East Lothian AHPs[1] in supporting East Lothian residents attending Accident and Emergency or being admitted to the Edinburgh Royal Infirmary or Western General Hospital. The Inreach project aimed to achieve better outcomes for patients by preventing admission and reducing the length of hospital stay.

The Inreach pilot contributed to a reduction in hospital length of stay from 16 days to 5 days for patients seen by the team and saved 1,320 bed days over the lifetime of the Pilot.

 

Partnership collaborations

Working collaboratively with community partners has resulted in the development of services during the year. 

The East Lothian Community First Service was launched to provide support to people struggling with their health and wellbeing by helping them to access community services.  The service also provides support to people leaving hospital and helps to prevent hospital admission / readmission.  Community First is delivered by VCEL (Volunteer Centre East Lothian) with funding from ELHSCP. Over 170 people benefited from the Community First service from October 2022 to March 2023.

East Lothian’s first Meeting Centre opened in Musselburgh, providing innovative, peer and carer led, community-based support for people with mild to moderate dementia and their families and friends. The Centre has been developed through a co-production approach and is delivered by DFEL (Dementia Friendly East Lothian), with grant funding from ELHSCP. 

 

Prevention and early intervention

The use of the East Lothian Rehabilitation Service (ELRS) Single Point of Contact (SPOC) phoneline grew over the year[2]. The phone line allows people to contact the service directly through one central system, and then speak to the professional who is best placed to help. The phone line can be used for self-referral, professional referral, or enquiries from existing patients. Almost 41,500 calls have been handled since the phoneline was launched in June 2021  

ELRS continued to develop the ‘Access to a Better Life in East Lothian’ digital platform, providing information and tools to support people to manage their own health and wellbeing. The platform includes information on the LifeCurve, support on self-management, and details of how to contact and self-refer to ELRS services. Also included is an interactive Body Map and Smart House.

The CWIC (Care When it Counts) Mental Health service provides easily accessible support for people with a range of mental health issues. Since its introduction, the service has demonstrated the effectiveness of this early intervention approach and has been positively received by patients and medical staff.

CWIC MH delivered over 6,000 appointments during 2022/23, averaging at around 512 appointments per month. A growing number of people now ‘self-refer’ to the service – with the proportion rising from 15% in 2021/22 to around 28% in 2023/24.

 

Vaccinations

East Lothian had the highest uptake of COVID and Flu vaccinations across all Lothian HSCPs during Autumn / Winter 2022/23. 72% of all eligible adults received a COVID vaccination (compared with an average of 67% across Lothian) and 88% of residents over 65 received a Flu vaccination (Lothian average – 85%)

 

Care at Home

The HSCP increased the number of Care at Home hours it provides directly by over 1,000 additional hours a week. This helped to make up for some of reduction in hours previously provided by external Care at Home providers who continued to struggle with pressures including staff shortages.

 

Hospital services closer to home

The number of outpatient services and clinics offered at East Lothian Community Hospital (ELCH) continued to grow during 2022/23. The number of outpatients seen at ELCH has increased from around 30,000 in the last years of Roodlands Hospital[3] to just over 55,000 in 2022/23 (a 60% increase). Developments at ELCH included:

• introducing nurse-led minor operations clinics
• doubling the capacity of Dermatology Ultraviolet Phototherapy treatment
• more than doubling the capacity of the Endoscopy and Day Services Unit
• working with the Haematology Unit at the Edinburgh Cancer Centre to provide Intravenous (IV) therapy at ELCH as an alternative to travelling to the Western General

 

Transforming community services

Progress continued to be made on delivering the IJB Community Transformation Programme. The Programme focuses on developing community capacity and support for older adults (65+), and adults under 65 with disabilities or mental health support needs.

The Resource Coordinator Team continued to grow, supporting more people with learning disabilities to access community-based activities, and expanding to cover Dunbar and North Berwick areas. By the end of the year, 238 people were accessing a range of community based sessions focusing on physical activity and skills development – these include life skills, college outreach, arts and crafts, cooking, mindfulness, yoga, gardening, bowling, swimming, and table tennis.

Further development of Neighbourhood Networks saw the introduction of a new network in Dunbar and a network based in Musselburgh for young people moving to adult services. Over 50 people are now benefitting from support provided by Neighbourhood Networks.