Public Engagement Survey on the IJB's future budget decisions

Introduction

The importance of this survey

Context

Balancing the Budget: The Financial Context

Pressures on Renfrewshire IJB's budget

How we will use the information you provide

Introduction

Renfrewshire Integration Joint board (IJB) is responsible for planning and overseeing social care and health services for adults, and health services for children, across Renfrewshire.  This includes making decisions about what services are delivered and how available budgets are spent.  On behalf of the IJB, Renfrewshire Health and Social Care Partnership, which consists of NHS Greater Glasgow and Clyde and Renfrewshire Council, has responsibility for delivery of these services, which include:

·         Adult and older people community social care services.  This includes, for example support for people with drug and/or alcohol issues, people with a learning disability, Residential Care, and Care at Home.

·         Renfrewshire Community Health Services. For example, this includes District Nursing, Health Visiting, Mental Health and Learning Disability Services.

Renfrewshire IJB currently also has responsibility for managing some services on behalf of other IJBs in the wider Glasgow area. These are Podiatry and Primary Care Support, with responsibility for GP Out of Hours service currently with Renfrewshire on an interim basis.

Renfrewshire has a range of services that respond each day to the needs of local people. There are 27 GP practices, 42 community pharmacies, 22 community ophthalmic practices and 36 general dental practices.  There are just over 183,000 people registered with 27 Renfrewshire GP practices. 

Renfrewshire IJB, like many other IJBs and organisations across the public sector, is currently facing unprecedented financial pressures. It also has a legal duty to set a balanced budget. At its meeting on 25 September 2024, the IJB agreed that savings of 10% against influenceable budgets should be identified to meet the financial challenge. 

The IJB has therefore launched this survey to seek the views of Renfrewshire residents on how health and social care services can best be delivered within the budget we have available. The closing date for responses is Friday 25 October 2024.

More information on the HSCP and Integration Joint Board (IJB) is available at Renfrewshire Health & Social Care Partnership and https://www.renfrewshire.hscp.scot/IJB.  

The importance of this survey

Against the backdrop of financial challenges described above, and to enable a balanced budget to be set in 2025/26, Renfrewshire IJB will have to consider a range of options.  These could involve:

• Reducing, changing or stopping some of the services we provide.
• Using technology better and more frequently.
• Using property differently.
• Looking at different approaches to delivering our services.

It is important that we gather a range of views and we are therefore seeking your feedback on how acceptable changes like this would be to you.  This is an anonymous and voluntary survey. However, if you would like us to contact you directly there is an opportunity for you to give us your details within the survey.

We provide further information on how we will use and protect the information you give us below.

This survey is also available in other languages and formats. Please contact renfrewshire.hscp@ggc.scot.nhs.uk should you require this service.

You can also give your views using a paper copy of the response form. If you would like a paper copy, please call 0141 487 2888 or contact renfrewshire.hscp@ggc.scot.nhs.uk, so that we can make arrangements to send this to you. 

Please visit www.renfrewshire.hscp.scot/IJBEngagement to complete the online survey.

Context

Renfrewshire Facts

Renfrewshire is the 10^th largest Council in Scotland by head of population but covers a relatively small land mass of 270 square kilometres. The semi-rural nature of much of Renfrewshire means there can be challenges with travel and staff recruitment.

Deprivation

The Scottish Index of Multiple Deprivation (SIMD) ranks all datazones in Scotland by a number of factors; Access, Crime, Education, Employment, Health, Housing and Income. Based on these ranks, each datazone is then given an overall deprivation rank, which is used to split datazones into Deprivation Quintiles (Quintile 1 being the most deprived, and Quintile 5 the least). The most recent SIMD ranking was carried out in 2020.

Of the 2021 population in Renfrewshire, 23.9% live in the most deprived Quintile (SIMD 1), and 22.5% live in the least deprived Quintile (SIMD 5).

General Health

In the latest NRS data for Renfrewshire HSCP:

• The average life expectancy is 75.5 years for men and 80 years for women. This is slightly lower than the Scotland averages of 76.5 for men and 80.8 for women.

• There were 2,195 deaths in Renfrewshire in 2023. This is a 3.1% increase from 2,130 deaths in 2022.

• 22.9% of people have at least one long-term physical health condition, higher than the Scotland average of 21.7%.​

• 21.1% of people take medication for mental health conditions like anxiety, depression, or psychosis, which is higher than the Scottish average of 19.3%.​

• 643 people per 100,000 were diagnosed with cancer, slightly more than the 625 per 100,000 across Scotland. Early cancer deaths (under 75 years) are also higher, with 173 per 100,000 compared to 153 in Scotland.

Hospital and Community Care

In the latest data for Renfrewshire:

• There were 16,543* emergency hospital admissions (18+) in 2023/24, an increase from 15,068 the previous year.

• There were 131,741* unscheduled acute bed days in 2023/24, a decrease from 134,205 the previous year.

• A&E visits (18+) were higher, with 42,019 in 2023/24 compared to 38,889 the previous year.​

• Delayed discharge bed days were much lower, with 5,194 in 2023/24 compared to 7,006 the previous year.

• There were 2,041 emergency hospital admissions due to falls in people over 65, which is lower than the Scottish average of 2,281.

• Emergency readmissions within 28 days were 81.4 per 1,000 discharges, lower than Scotland's rate of 106.5.

• Potentially preventable hospital admissions were lower at 1,278 per 100,000 people, compared to 1,464 in Scotland.​

* Provisional 

Unpaid Carers

In the latest data for Renfrewshire:

• Around 17% of the adult population of Renfrewshire take on unpaid carer responsibilities.

• Around 3,000 unpaid carers are currently known to local services, and the number of new carers getting support has been steadily increasing.

Balancing the Budget: The Financial Context

Further information on the IJB's budget

Renfrewshire IJB's budget breaks down in many ways.  Some examples include:

• The IJB has a total gross budget of £410.6m.

• £190.2m of this budget is 'ring-fenced' which means there are rules about how that money must be used.  These can be set by the Scottish Government or the Health Board. An example of this is the 'set aside' budget of £66.6m, which covers Renfrewshire's contribution to acute hospital services delivered by NHS Greater Glasgow and Clyde.

• This leaves £220.4m where the IJB can be more flexible and look to identify budget savings. Within this figure, our service budgets are shared as shown in the table below.

We spend our budget in lots of ways to meet the needs of vulnerable people in Renfrewshire.  For example:

• We spend approximately £40.4m on services for people with a learning disability.  Around £230k of this is ring-fenced.
• Addictions services (including Alcohol and Drug Recovery Services and the Alcohol and Drug Partnership) have a budget of just under £3.8m, but a large amount of this, £2.4m, is ring-fenced.

What we spend by the end of each year might look different from our budget figures depending on range of factors including the cost of supplies, our ability to fill vacant posts, and the demand for services.

Pressures on Renfrewshire IJB's budget

There are significant financial pressures facing the Scottish Government and IJBs across Scotland. Renfrewshire IJB faces the same challenges.  For example, the Scottish Government has announced a focus on reducing non-essential spend and recruiting to essential posts only to deliver in-year savings of £500m. Within Renfrewshire, in April 2024 we were projecting:

• The current estimated net funding gap for 2024/25 is £10.7m. 

• The estimated net recurring gap increases to circa £22.9m in 2025/26 by which time most of the IJB's reserves are expected to have been utilised.

These figures change over time as we get more information however they reflect a range of issues which are increasing the cost of health and care services in Renfrewshire.   Some examples of these include:

• Significantly increasing prescribing costs as well as an unprecedented number of prescription items being in short supply.

• Our commitment to funding fair pay awards and additional pay-related commitments made by the Scottish Government.

• Ensuring that our Care at Home service continues to support people to live safely at home for as long as possible and our commitment to helping people to be discharged from hospital as soon as they are well enough.

• The increasing cost of contracts that we have in place to support people in Renfrewshire, because of challenges such as inflation.

• Increased and more complex needs for people being discharged from hospital and being supported in their own homes.

How we will use the information you provide

Although this survey is anonymous, should you choose to provide your contact details this will be personal information. Any personal information collected will be processed in accordance with UK GDPR ("General Data Protection Regulation") and the Data protection Act 2018. It will be used only for the purposes of contacting you.

The survey has been developed in line with Renfrewshire Council and the IJB's public functions. This includes making decisions around savings, strategic planning, and budget and transformation programmes. We might also use data you provide for research purposes. An analysis of responses provided will be used to inform the development of savings options for the IJB's consideration and will be included in reports submitted to the IJB, Renfrewshire Council and NHS Greater Glasgow and Clyde for consideration.  IJB reports are published on the HSCP's website. Any information re-produced for these purposes will not be identifiable to any individual.

Further information on how the Council handles your personal information can be found at: http://www.renfrewshire.gov.uk/article/2201/Privacy-policy