Technology is set to be a ‘key enabler’ of Edinburgh’s new health and social care strategic plan, which was published today.

Devices which can provide assisted living capabilities could be explored as part of a new focus around a ‘home first’ policy – which seeks to reduce strain on acute medical services and respond to growing demand.

The new vision, which was unveiled by Edinburgh City Council, seeks to ‘maximise the opportunities for use of existing and new TEC [Technology Enabled Care] solutions and ensure this is at the heart of our prevention approach.’

Among the potential developments will be greater use of technology to support independent living in social care housing, with the plan stating: “The HCS (Housing Contribution Statement) outlines the plans to ensure new homes meet future needs, new models of housing and care are developed in local communities and housing and health and social care partners jointly develop new technology which can be embedded in homes to support independent living.’

The plan adds: “We need to continue to work with 21st Century homes to provide accessible properties that can meet people’s support needs. In doing so, to maximise the use of assistive technology to enhance people’s independence.”

The Edinburgh Integration Joint Board (EIJB), which oversees the delivery of services which support the wellbeing of adults in the Capital, says it will ‘radically transform’ the way Edinburgh delivers its health and social care services over the next three year planning cycle and beyond.

Under its new Strategic Plan, approved on Tuesday (20 August), the EIJB says it will further integrate Council and NHS services to deliver an ‘affordable, sustainable and trusted health and social care system’ under its vision for a “caring, healthier and safer Edinburgh”.

Ricky Henderson, Vice Chair of the EIJB, said: “Edinburgh’s population is expected to increase faster than any other city in Scotland and with that comes a number of very real challenges. The number of residents who are aged 85+ is expected to more than double over the next 20 years. We need to accept that the status quo is unsustainable in the long term and our care systems need to evolve. Our Strategic Plan identifies new ways of delivering care so that we can better meet the current and future needs of Edinburgh citizens and, crucially, work to improve the population’s overall wellbeing.”

As part of the Strategic Plan, a bespoke ‘Edinburgh Offer’ or pact will tackle inequalities so that age, disability, and health conditions are no longer barriers to living a safe and thriving life. Promising better collaboration between healthcare providers and local communities and working closely with the Council’s housing and homelessness services, the Edinburgh Offer will focus on helping people to live independently for longer, shifting the balance of care from hospitals to the community under a ‘Home First’ approach.

A move towards a more flexible way of working is planned with the transformation of the EIJB’s services, to reduce overlap, modernise systems and concentrate resources in new ways. A preventative and person-centred approach to care will be championed under what is hailed the ‘Three Conversations Approach’, which will promote tailored care for each individual, in a place which is best for them, as early as possible. The Three Conversations Approach provides three clear and precise ways of interacting with people that focus on what matters to them:

-Conversation 1: Listen and Connect.
-Conversation 2: Work intensively with people in crisis.
-Conversation 3: Build a good life.

The Three Conservations approach is also seen as a more humane and responsive way of dealing with people’s day-to-day lives and requirements than previous transactional approaches which have been around ‘process’.

Innovation sites are being established around the city (as of last month) with ‘new rules and new practice, developed through coaching and mentoring, building a qualitative and quantitative evidence base. Partners4Change (P4C) will be working with the Edinburgh Health and Social Care partnership (EHSCP) and partners to implement the model across the city’.

Judith Proctor, Chief Officer for the EIJB, added: “This is the first step on a long journey which will only work if we improve integration and redesign certain services. Our plans are very ambitious because we need to be bold – Edinburgh deserves the very best that we can offer.

“That’s why at the heart of this Plan is a desire to improve the experience of patients, families and carers across the board. The conventional approach to care makes people wait for an assessment and is about processes, not people. That’s something I’m passionate about changing. We need to abandon the jargon and work in a way which is much more meaningful for families.”

Details of the Strategic Plan’s vision and values have been published following a 77% approval rating on a draft which was published in March. A public consultation on the draft plan engaged over 450 people including citizens, carers, health and social care professionals and partners in the third and independent sector and included 106 online results, which saw 78% of respondents agree with the EIJB’s proposed intent to concentrate resources in the community rather than hospital settings. A further 76% agreed with the principles of a redefined Edinburgh Offer.

The consultation feedback has fully informed the final version of the Strategic Plan which is a significant re-write of the initial draft released in March.

Ella Simpson from EVOC said: “It is so important for Edinburgh’s voluntary and community organisations to have a voice and shape decisions which are made about health and social care. That’s why EVOC, as a board member of the EIJB, has been heavily involved in the development of the Strategic Plan.

“The voluntary and community sector has been involved throughout the development of this plan and our intimate knowledge and understanding of people’s needs are reflected in the plan. The result is a collaborative vision.  The hard work starts now as we work together to realise the ambition of the plan.”

The agreed budget for this financial year (2019/20) is estimated at £666m; the initial assessment of the cost of delivering the strategic plan in 2019/20 is £684million, according to the paper, which means a requirement to save £24 million, or 3.6%. The report adds: “This level of efficiency, set against a background of increasing pressure on services, is challenging.”

The document goes on to say that EJIB’s financial strategy focuses on ‘driving out waste and service redesign’ and that it is confident that the transformation programme will assist in delivering those ‘efficiencies’.

For context, the plan highlights a number of concerns around health and social care sustainability raised in a recent Audit Scotland report, including:

-A 12% increase expected in GP consultations.
-A 33% increase in the number of people needing homecare and a 31%. increase in those requiring ‘intensive’ homecare.
-A 35% increase in demand for long-stay care home places.
-A 28% increase in acute emergency bed days and a 16% increase in acute emergency admissions.