Prevention Strategic Plan 2015-18

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FOREWORD

Michelle Miller, Chair, Prevention Strategy Steering Group

Welcome to the first Prevention Strategic Plan produced by the

Edinburgh Partnership.

Prevention is about doing things earlier and differently to improve

outcomes for people and make better use of resources. It is of

critical importance in a rapidly changing environment of rising

expectation, increasing demands for services and financial

constraints. Making the shift to prevention is a challenging

aspiration, but one which presents opportunities for city partners to

innovate and work creatively with communities. Increasing

preventative efforts also will help to address the negative

outcomes, which many of our citizens still face.

The Strategic Plan summarises work carried out over the last year

to help refine a city approach to prevention. The document

represents a step on what will necessarily be a long journey, which

requires strong partnership working, difficult decisions and resource

shift. Much good work is already being done in the city. The

challenge now is for partners and partnerships to build on existing

efforts and to use this strategy to inform additional preventative

actions across the whole spectrum of public service activity.

I am excited about Edinburgh’s commitment to this challenge and

look forward to reporting progress over the life of the plan.

Michelle Miller

Chair of Prevention Strategy Steering Group

June 2015

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Edinburgh Partnership – Prevention Strategic Plan 2015-18

PART ONE

INTRODUCTION AND DEFINITIONS

Introduction

This document sets out the Edinburgh Partnership’s i strategic

approach to making an enhanced shift to ‘prevention’. It has been

prepared under the direction of the Partnership’s Prevention

Strategy Steering Group.

The Prevention Strategic Plan is underpinned by the delivery of

existing and planned preventative actions aligned to the outcomes

in Edinburgh’s Community Plan (2015-18)ii. This strategy also sets

out the Edinburgh Partnership’s agreed principles to inform city

partners’ work on prevention, as well as a set of priority enablers

to support the shift to prevention. Summary details are provided

on a set of prevention ‘exemplar’ projects or initiatives, as well as a

read-across to the Community Plan.

Approaches to measuring prevention are complex, but will be

addressed during the life-time of this strategy, which will be

overseen by the Edinburgh Partnership Board and relevant groups,

through periodic monitoring and evaluation. It complements the

Partnership’s Community Plan and should be read alongside it.

What is Prevention?

There are many definitions of prevention in public services. The

Edinburgh Partnership has adopted the broad definition proposed

by the Scottish Government:

“Actions which prevent problems and ease future demand on

services by intervening early, thereby delivering better outcomes

and value for money.” iii

This definition highlights the importance of early intervention in

improving outcomes for people. The dual aspects of better life

chances and improved value for money are fundamental.

In addition to this overarching definition, the Partnership

recognises a continuum of prevention, ranging from:

‘primary’ or ‘upstream’ approaches (including whole

population approaches and/or services and interventions

for people with lower level needs)

through ‘secondary’ approaches – typically those directed at

people with emerging needs, in an attempt to stop these

getting worse; and finally

‘tertiary’ or ‘downstream’ approaches to prevention, usually

targeted at people with a range of complex needs and/or

more pronounced ill-health, focused on maintaining stability

and preventing deterioration for as long as possible.

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Scope of the Strategic Plan

The focus of this strategy and action plan is on the social

dimensions of citizens’ quality of life, as part of wider social

sustainability in Edinburgh. Prevention cuts across all community

planning priorities, including physical and environmental issues,

such as climate change, flooding, air quality and environmental

degradation. Strategies aimed at preventing or mitigating

environmental issues, including the requirements of the Climate

Change (Scotland) Act, iv are led by the city’s Sustainable

Development Partnership. v City partners will continue to develop

their understanding of the interdependencies of social and

environmental sustainability and how these contribute to

prevention.

Why Prevention? Background and Context

Preventative approaches are not new, although they have been

given added impetus over recent years, not least because of

financial austerity and demographic demands. The Independent

Budget Review Group, in 2010, vi stimulated debate on the future

funding of public services. The Commission on the Future Delivery

of Public Services (the Christie Commission) vii in 2011, and the

Scottish Government’s subsequent response, viii stressed the

importance of prevention as one of the four pillars of public sector

reform, alongside place, people and performance.

Christie reinforced the links between prevention and tackling

inequalities, citing previous evidence, which suggested that 40-45%

of public spending in Scotland is focused on meeting ‘failure

demand’, i.e. reactive spending responding to acute problems. The

report suggested that “The adoption of preventative

approaches…will contribute significantly to making the best use of

money….and critically, take demand out of the system in the longer

term.”

Prevention, Community Planning and Single Outcome Agreements

National Single Outcome Agreement (SOA) guidance ix issued to

community planning partnerships (CPPs) in late 2012 asked that

CPPs develop a prevention plan alongside their SOAs. In Edinburgh,

new partnership working arrangements to champion and further

co-ordinate preventative activity within the city were established in

2014, building on earlier work by the City of Edinburgh Council.

The Prevention Strategy Steering Group (‘the Steering Group’) is

chaired by the Council’s Chief Social Work Officer on behalf of the

Partnership.

Progress across Scotland in developing strategic approaches to

prevention remains at a relatively early stage. Audit Scotland’s

community planning report x (November 2014) notes that some

improvements have been made in CPPs’ understanding of their

collective resources and how these are used. Despite this, it also

states that “discussions about targeting these resources and

shifting them towards preventative activity are still in early stages.

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CPPs do not yet know what a strategic approach to prevention will

look like…. The current pace and scale of activity are contributing to

an improved focus on prevention, but is unlikely to deliver the

radical change in the design and delivery of public services called for

by the Christie Commission.”

The Edinburgh Partnership acknowledges the inherent challenges in

making a meaningful shift to prevention and increasing the push in

that direction. Public sector resources are under extreme pressure

and the demands of an increasing population and changing

demographics cannot be underestimated. Short-term political

cycles typically demand shorter term measures of success. Levels

of poverty and inequality in the city – linked to longer term

negative and costly outcomes – remain significant.

Despite these challenges, to do nothing is not an option, and the

potential benefits of effective prevention make it essential to apply

a comprehensive and strategic approach. The Partnership has

agreed this initial Strategic Plan and will continue to develop its

thinking, policy and practice on prevention. The Plan is a starting

point for what will necessarily be a long-term consideration for city

partners. More distant horizon-scanning is required – a gradual

swing towards prevention is more likely to be achievable than a

short-term decisive shift. Both to develop a shared understanding

and to make prevention a reality, the combined resources and

expertise of city partners, including citizens, together with the

Scottish Government, academics and national agencies are

required.

Current Preventative Activity

In developing this strategy, priority has been given to establishing

future prevention priorities for the Edinburgh Partnership over

2015-18, rather than auditing all current preventative activity.

There are, however, many strong examples of existing activity and

areas of innovation, which aim to deliver on the prevention agenda,

for example the work over recent years on Total Craigroyston (see www.totalcraigroyston.co.uk).

Total Craigroyston in North West Edinburgh was established by the

Edinburgh Partnership, with a focus on children and families, taking

a holistic approach to ensuring that necessary supports are in place

to improve the experiences of and outcomes for the local

community. It has had a particular focus on children looked after

by public authorities (and on identifying ways to offer support at

earlier stages to reduce the need for children to become looked

after by the Council). It embodies a very strong preventative

approach, with robust partnership working around agreed

outcomes, with service users at the centre of collaborative planning

and decision making.

A set of case studies of existing prevention initiatives, including Total Craigroyston, is being co-ordinated by the Prevention Strategy Steering Group and will be available from summer 2015.

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PART TWO

OVERVIEW OF STRATEGIC PLAN

This Prevention Strategic Plan reflects work undertaken by the

Steering Group over 2014 and also draws from the parallel process

of developing the Community Plan.

The Strategy is made up of four elements:

a set of prevention principles to inform city partners’ work

on prevention

a set of priority prevention enablers to support the shift to

prevention, drawn from an analysis of intractable issues in

the city

a selection of prevention ‘exemplars’, projects/initiatives in

the city, at a new or early stage, which are anticipated to

deliver on different aspects of prevention; and

the delivery of prevention through existing and planned

actions aligned to the priority outcome areas in the

Community Plan 2015-18.

The Action Plan includes actions for city partners and partnerships

to help deliver the strategy.

In summary, this document provides a high level framework and

statement of intent for the Edinburgh Partnership. It is designed to

help in the next stage, that of further embedding prevention into

city partners’ and partnerships’ work. Success will depend largely

on the recognition that prevention is everyone’s business and

everyone’s responsibility, regardless of the services they provide.

The Strategy’s Prevention Principles

Staff engagement led by the Council in late 2013xi reviewed existing

approaches to prevention and considered what more was needed

to increase momentum and develop successful preventative work

in Edinburgh. The key messages from that exercise have been

distilled into a set of strategic principles to underpin our work:

1. Prevention will be mainstreamed across all of the Edinburgh

Partnership’s activity, embedded as a priority and a collective

responsibility for all city partners and communities.

2. A decisive and long-term financial and operational shift to

prevention will be made, through mainstream services and new

initiatives.

3. Genuine engagement with citizens and communities, which

builds on their assets and establishes trust, is essential to

successful preventative action.

4. Effective information, advice and communication will be

promoted as key elements of prevention.

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5. Services will focus on building resilience through establishing

positive and supportive relationships between providers and

service users, families and communities.

6. Tackling poverty and inequality will be prioritised as core

elements of an effective prevention response.

7. Prevention will be addressed across the life course, from

developmental support in early years, to maximising wellbeing

in later years.

8. Measuring, understanding and sharing what works are core to

the successful implementation of an effective prevention

strategy.

9. A successful and long-term shift to prevention depends on an

engaged, knowledgeable and committed workforce, trusted by

the community it serves.

The Strategy’s Prevention Enablers (addressing intractable issues)

Consultation across the Edinburgh Partnership in 2014xii set out to

establish more precisely the perceived ‘wicked’ or intractable issues

in need of increased joint effort to support an enhanced shift to

prevention. Analysis of the responses revealed a number of core

themes for new or additional action by city partners:

a) Improved Information Management and Use of

Information Technology

b) Enhanced Co-ordination and Timing of Service Delivery

c) Developing approaches to Whole Household and/or Family

Support

d) Building Resilience and Community Capacity

e) Developing an enhanced Neighbourhood Focus (including

improving the physical environment)

f) Supporting People with Multiple and Complex Needs

g) Tackling Poverty (including child poverty, economic

inequality and health inequalities)

Fuller details are presented in Appendix A.

The prevention enablers above are of relevance to all city partners

and constituent partnerships. Prevention ‘exemplars’, which will

help to make more progress on the enablers and act as focus for

learning are described below.

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The Strategy’s Prevention Exemplars

The prevention exemplars represent new, early stage or

developmental prevention activity and are aligned to one or more

of the priority prevention enablers detailed at a-g above. Given the

fluidity of the prevention agenda, this set will remain dynamic and

can be added to over the course of this strategy and action plan.

This set of projects will be examined by the Prevention Strategy

Steering Group and the Edinburgh Partnership every 12 months, as

part of overall arrangements to assess progress on the prevention

agenda.

By focusing on the practice and learning developed through a core

set of projects, it is anticipated that collective learning can be

achieved for the projects and for the Edinburgh Partnership. In

turn, this will help inform future prevention practice.

The composition of the set of exemplars was sense-checked

through logic modelling, establishing that the projects have a

number of common themes and policy coherence.

The prevention exemplar projects identified for focus in the first

year of this plan are set out below.

1) Piloting an extension of the Family Group Conferencing/Family

Group Decision Making approach (currently used in Children’s

Services) into a range of adult settings. The model enables a

wider group of people – traditional or non-traditional ‘families’ -

to take a core role in shaping a care plan for and with their

relative or friend. This approach fits primarily with the

prevention enablers of whole household and family support and

building resilience (lead: Council Children and Families and

Health and Social Care).

2) Delivering the ‘Headroom’ Project with GPs and patients in a

number of practices in East Edinburgh. This project will enable

several GP practices to pilot different approaches to more

effective and patient-centred primary care interventions,

including use of social prescribing models. This approach fits

mainly with the prevention enablers of tackling poverty and

inequality, and building resilience (lead: NHS Lothian, linked to

Total Neighbourhood East).

3) New approaches to locality and neighbourhood working,

building on existing neighbourhood models, including Total

Place. The focus is in South-West Edinburgh and is linked to the

Council’s Transformation initiative (previously BOLD). Five

themes – starting well, living well, working well, staff

development and community capacity building – form the basis

of this new locality-based project. This approach fits with a

number of prevention enablers, including locality working and

improved co-ordination and timing of service delivery (lead:

Council Transformation SW Project).

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4) Implementation of the Safe and Together model of training for

lead professionals in the field of domestic abuse. This follows

from an assessment that new training is required to ensure

practice is more preventative and that better outcomes are

achieved. The model promises a best practice approach to

helping partner agencies make good decisions for children

impacted by domestic abuse. This initiative fits mainly with the

prevention enablers of improved co-ordination and timing of

service delivery and whole household/family support (lead:

Chief Officers’ Group, Public Protection).

5) Development of a strategic approach and action plan to tackle

Child Poverty in the city. An overarching poverty and inequality

framework is in place in the city; however, additional focus is

required in terms of tackling child poverty, in line with the

Scottish strategy. The approach will be built around the

domains of ‘pockets’, ‘prospects’ and ‘places’. A strategic

approach to child poverty will support a number of the

prevention enablers, including tackling poverty and inequality

and whole household or family support (lead: Children’s

Partnership).

6) Inclusive Edinburgh – (development of enhanced service

responses to address the needs of people with multiple and

complex needs). This project was established in 2014 to review

approaches to supporting people who may struggle with issues

including homelessness, unemployment, drug/alcohol

problems, violence, ill health and crime. The project is exploring

how to work better together to improve the lives of the

individuals affected. This initiative links primarily with the

prevention enablers of tackling poverty and inequality and

supporting people with additional and complex needs (lead:

Inclusive Edinburgh Board – multi-agency/multi-sector).

7) ‘Getting it Right for Everyone’ – this is the working title of an

initiative in its early stages, which aims to pilot an extension of

‘Getting it Right for Every Child’ (GIRFEC) into adult settings.

The pilot will identify aspects from the GIRFEC approach that

can be used to promote enhanced joint working and joint

understanding of need. This will help to ensure that the right

support is provided at the right time, for the right time. The

pilot work is part of Total Neighbourhood East. As a prevention

exemplar it is particularly linked to the prevention enabling

themes of improved information management and improved

co-ordination and timing of service delivery (lead: Council

Children and Families, linked to Total Neighbourhood East).

8) Reinforcing the city strategy to tackle alcohol-related harm as

a ‘whole population’ issue of relevance to the entire Edinburgh

Partnership and across life stages. The annual cost to the city of

alcohol-related harm is estimated at around £221 million. 47%

of people in Edinburgh drink more than recommended limits on

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a weekly basis and around 20, 000 people are dependent

drinkers. Significant culture change is required to help prevent

chronic problems, including alcohol-related crime and early

death and morbidity. Within its strategy, the Edinburgh Alcohol

and Drug Partnership is developing a preventative model,

moving from trauma through to recovery, as well as an

approach to reduce the availability of alcohol. An enhanced

response to tackling alcohol-related harm as a prevention

exemplar links with a number of prevention enablers, including

tackling poverty and inequality and health inequalities;

supporting people with multiple and complex needs; and whole

household and family support (lead: Edinburgh Alcohol and

Drug Partnership).

9) Local Outcomes for Older People (LOOPS) – the LOOPs

Initiative is established to ensure that Edinburgh’s older people

are provided with additional opportunities, as well as

information and signposting, to access third sector

preventative health and social activities. The main aim is to

support existing efforts by the statutory and third sectors,

building on the work of the Reshaping Care for Older People

Change Fund. LOOPS’ main aim is to help shift the balance of

care from institutional to community settings, by improving

early uptake of such services. This helps to delay the onset of

avoidable crises, as well as ensuring that older people who are

assessed as requiring a statutory service are provided a full

range of additional resources to promote independence and

wellbeing (lead: LOOPS Steering Group and Older People’s

Management Group).

The initial projects described as exemplars have been chosen as

new, early stage or developmental approaches, which will help to

deliver on the principles and enablers identified in this strategy. As

with any selection of key initiatives, they represent only a small set

of preventative action in the city. Action for the Prevention

Strategy Steering Group over 2015/16 includes developing

monitoring and evaluation arrangements on the preventative

aspects of these projects, working in conjunction with the

individual exemplar leads.

Prevention delivered through the Community Plan (SOA) 2015/18

Building on the principles, prevention enablers and exemplars

identified above, the fourth component of the Prevention Strategy

is that prevention continues to be embedded in the policies and

action plans that support the development of the Community Plan.

In the process of selecting a set of new or early stage exemplars for

closer examination and learning opportunities, it was clear that

many other projects with preventative objectives are in place

across the city. Central to this wider preventative action is the

Community Plan. It highlights a number of preventative

commitments to action, which will help deliver on its core

outcomes and priorities.

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To achieve the overall city vision that “Edinburgh is a thriving,

successful and sustainable capital city, in which all forms of

deprivation and inequality are reduced”, four core outcomes,

underpinned by a number of strategic priorities, have been

identified. These are detailed below, with examples of linked

preventative action, as highlighted in the Community Plan.

Economy: Community Plan Outcome: Edinburgh’s economy

delivers increased investment, jobs, and opportunities for all

Strategic Priority: reducing unemployment and tackling low pay.

Prevention: preventative action to deliver on this priority includes programmes to increase youth employability.

Health: Community Plan Outcome: Edinburgh’s citizens experience improved health and wellbeing, with reduced inequalities in health Strategic Priorities: shifting the balance of care; reducing alcohol and drug misuse; and reducing health inequalities Prevention: preventative action to deliver on these priorities includes the co-productive development of further prevention programmes to reduce health inequalities. Children and Young People: Community Plan Outcome: Edinburgh’s children and young people enjoy their childhood and fulfil their potential

Strategic Priorities: improving early support; improving outcomes for children in need; improving positive destinations Prevention: preventative action to deliver on these priorities includes the delivery of the Early Years Collaborative and the Early Intervention Change Fund. Communities: Community Plan Outcome: Edinburgh’s communities are safer and have improved physical and social fabric Strategic Priorities: reducing antisocial behaviour, violence, and harm; reducing re-offending; improving community cohesion, participation and infrastructure; increasing availability of affordable housing; and reducing greenhouse gas emissions. Prevention: preventative action to deliver on these priorities includes delivering a partnership model on fire prevention for people with vulnerabilities; supporting effective practice with women offenders; and addressing prolific offending in local communities. Summary

This section has set out the four core dimensions of the strategy.

Principles and enablers are essentially about ways of doing things

to achieve prevention. Exemplars and wider preventative actions

are the some of the projects and initiatives which aim to deliver on

prevention.

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Developing the measurement and impact of preventative activity;

making a shift to more ‘upstream’ interventions; helping to build

resilience and capacity to reduce demands on public services; and

securing the resources, joint commitments and leadership to make

prevention a reality are all extremely challenging.

The role of the third sector, as often the first point of contact with

citizens and communities, with its sophisticated understanding of

needs, remains central to prevention. Community resilience and

active citizenship are likely to play increasingly important roles in

prevention and wellbeing. These themes are also central to the

wider move to locality working in the city and are at the core of

Edinburgh’s vision for Community Learning and Development.

Edinburgh is not alone in prioritising a focus on prevention. It is a

major public service issue, not least for financial and social justice

reasons. This Strategy is the beginning of a longer term movement

to address the complexities and to mainstream prevention at the

core of the Partnership’s work.

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PART THREE

Action Plan

This part of the document sets out initial actions to deliver the strategy described above. Broadly, these actions combine how the Edinburgh

Partnership will mainstream prevention; with whom it will work; and the areas on which to focus in order to make a recognisable shift to

prevention. The Action Plan will continue to be refined by the Prevention Strategy Steering Group, with annual progress reporting. All city

partners and partnerships within the community planning/Edinburgh Partnership framework have a key role in delivering these actions.

Ref Action By (Lead/s, Time) AP1.1 Embed prevention in the Community Plan, develop a linked prevention strategy and plan and develop appropriate

measures and evaluation to assess progress on an annual basis. Prevention Strategy Steering Group, working with all relevant partners. By March 2016

AP 1.2 All strategic and cross-cutting/other partnerships and partners to use the prevention strategy as a framework to develop prevention plans and/or ensure a preventative approach is embedded in their core strategies and plans; reporting annually to the Edinburgh Partnership on progress in ‘making a shift’ to prevention. In particular, partners and partnerships will use the prevention principles to inform their work and seek opportunities to develop new and additional preventative work linked to the prevention enablers.

All partners and partnerships in the Edinburgh Partnership ‘family’. Progress over 2015/16, with reporting at year end in 2016/17/18.

AP 1.3 The Edinburgh Partnership will consider the best approach/es across the city to the sharing of learning on prevention, including working with national bodies and networks as appropriate.

Council Corporate Policy and Strategy Team working with Prevention Strategy Steering Group. By mid 2016.

AP 1.4 The role of the Prevention Strategy Steering Group will be developed further within the Partnership’s structures to ensure appropriate oversight of the prevention agenda and appropriate support for the Edinburgh Partnership Board.

Chair and Prevention Strategy Steering Group Summer 2015.

AP 1.5 Review models in use elsewhere, which aim to support the leadership and scrutiny of the prevention agenda (e.g. Early Action Commissions) and assess applicability for Edinburgh context.

Prevention Strategy Steering Group. Summer 2015.

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Ref Action By (Lead/s, Time) AP 1.6 To help enable a financial/operational shift, partnerships will develop their understanding of how much of their

expenditure is ‘reactive’ and ‘preventative’, and set appropriate targets for shifting more expenditure into prevention. Where possible, projects will set targets to make savings through preventative work.

All partners and partnerships in the Edinburgh Partnership ‘family’, working with finance officers. Progress over 2015/16, with reporting at year end in 2016/17/18.

AP 1.7 Partners/partnerships to build prevention into their budget setting and savings programmes, e.g. by considering the impact of any proposed savings on prevention.

All partners and partnerships in the Edinburgh Partnership ‘family’, working with finance officers. Embed in budget processes for 2016/17 and beyond.

AP 1.8 The Edinburgh Partnership will consider options for collectively moving more resources into prevention, as part of discussions on joint budgeting.

EP Board Report progress by end 2015/16.

AP 1.9 The Edinburgh Partnership will identify early opportunities to embed prevention into major city initiatives (for example Council transformation, development of locality working and health and social care integration).

EP Board, Corporate Policy and Strategy Team and Prevention Strategy Steering Group. Summer 2015

AP 2.1 Partnerships will work with communities to ensure best practice is adopted in community engagement and working from an assets-based approach, in supporting a strategic shift to prevention.

All partners and partnerships in the Edinburgh Partnership ‘family’.

Ongoing process.

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Ref Action By (Lead/s, Time) AP 2.2 Partnerships will work to co-produce preventative services with service users and communities, taking a whole-

household or family approach where possible.

All partners and partnerships in the Edinburgh Partnership ‘family’.

Ongoing process.

AP 2.3 The Edinburgh Partnership will seek the support of the Scottish Government in addressing the challenges of making a shift to prevention in the current socio-economic climate.

EP Board, Chair Prevention Strategy Steering Group, Scottish Government.

By Sept 2015.

AP 2.4 The Edinburgh Partnership will work with other community planning partnerships to share best practice and continue to make the case for prevention.

EP Board, EP Secretariat Team and Prevention Strategy Support. Ongoing.

AP 2.5 Edinburgh Partnership members will contribute to other national networks, including the Third Sector Roundtable on Prevention, to develop learning and share best practice on prevention.

EP Board, EP Secretariat Team and Prevention Strategy Support. Ongoing.

AP 2.6 Partners will work together to equip their workforce with the skills, knowledge and commitment to support a successful and long-term shift to prevention and to create trust with the communities they serve.

All partners and partnerships in the Edinburgh Partnership ‘family’. Report progress at year end 2015/16.

AP 2.7 Partnerships will develop their understanding of the preventative interventions, which must be delivered by others, including the Scottish and UK Governments, and will work with and seek to influence these other partners.

All partners and partnerships in the Edinburgh Partnership ‘family’, supported by Prevention Strategy Steering Group and EP Board. Ongoing.

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Ref Action By (Lead/s, Time) AP 3.1 Prevention will be embedded through relevant ‘commitments to action’ to deliver on outcomes and priorities in the

Community Plan; progress will be highlighted via reports on the Community Plan and on the Prevention Strategic Plan. All partners and partnerships in the Edinburgh Partnership ‘family’. Ongoing.

AP 3.2 An initial set of prevention exemplar projects will be developed and implemented over the lifetime of the Prevention Strategy. These will be a focus for learning and sharing of good practice and will help deliver on the prevention enablers identified as priorities for further action by the Edinburgh Partnership.

Exemplar project leads and project governance arrangements, working with Prevention Strategy Steering Group. Ongoing with annual reporting.

AP 3.3 Learning captured via the exemplars, via other existing preventative work in the city and via the work of the Prevention Strategy Steering Group will be summarised and disseminated across the Edinburgh Partnership, e.g. in the form of briefing papers and case studies.

Prevention Strategy Steering Group in conjunction with all partners and partnerships in the Edinburgh Partnership ‘family’. From Summer 2015.

AP 4.1 Tackling poverty and inequality will continue to be the core elements of a prevention response, supported by the city’s Poverty and Inequality Framework, Health Inequalities Framework and other relevant strategies and policies.

All partners and partnerships in the Edinburgh Partnership ‘family’ supported by the Poverty and Inequality Partnership and the Health Inequalities Standing Group. Ongoing.

AP 4.2 Approaches to prevention will underpin the development of locality working in the city, with action plans developed accordingly.

Edinburgh Partnership Board and all relevant partners/partnerships at

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Ref Action By (Lead/s, Time) locality level, working with Council transformation project team and Prevention Strategy Steering Group. From April 2015.

AP 4.3 Partnerships will develop their understanding of the evidence for the best preventative interventions and will focus their activity accordingly. Collaborations will be sought with others, including academics and the What Works Scotland network.

Prevention Strategy Steering Group in conjunction with all partners and partnerships in the Edinburgh Partnership ‘family’. From April 2015.

AP 5.1 Partnerships will develop preventative interventions across the life course of individuals, recognising the particular importance of early years and earliest intervention/anticipatory approaches. Focus will also be given to managing transition points in people’s lives (as key risk points, which can contribute to negative outcomes).

All partners and partnerships in the Edinburgh Partnership ‘family’. Ongoing.

AP 5.2 Partnerships will develop their understanding of the prevention continuum (from primary or upstream models, through to tertiary/downstream models) and use this to inform their investment in preventative work.

All partners and partnerships in the Edinburgh Partnership ‘family’. Ongoing.

Action Plan at June 2015 (will be kept under review)

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Appendix A

Identifying Wicked or Intractable Issues

In 2014, consultation was undertaken across the Edinburgh Partnership to help identify perceived ‘wicked’ or intractable issues, which need increased joint

effort to support a successful shift to prevention. The table below represents a grouping of the feedback into a number of common themes.

Priority Prevention Themes (cross-cutting enablers) for new/additional action for the EP

Summary of comments generated through Edinburgh Partnership consultation 2014

A) Improving Information Management and Use of Information Technology

This includes both better information sharing about people and/or sharing of information about services available in an area. Using IT to help identify people in need of early action/preventative interventions and managing ‘service users in common’ has significant potential. Knowing what (preventative) services are available in an area and how to access them can help individuals, communities and organisations to address issues earlier and improve resilience.

B) Enhanced Co-ordination and Timing of Service Delivery

Lack of service co-ordination and/or timely intervention has been highlighted as a major intractable issue, both within and between agencies and sectors. Particular risks have been identified around core transition points over the life course. Partnership approaches, including those based on ‘Total Place’ have the potential to make a positive difference in terms of better co-ordination and timing of service delivery. Early intervention and getting it right first time are important to help prevent longer term negative outcomes. Systems also need to be developed to understand better ‘what works’ and to translate good practice, as appropriate.

C) Developing approaches to Whole Household and/or Family Support

Interventions are often at the individual level, without due consideration of wider family structure, dynamics and capacity. This leads to missed opportunities to deliver holistic responses, which could maximise prevention and build on existing assets. Families also have an important role in decision making and there is potential to explore family group techniques used in children’s services, in an adult setting. There is also an opportunity to look at the application of the ‘Getting it Right’ methodology with adults.

D) Building Resilience and Community Capacity

Resilience at an individual and community level may be able to help prevent people needing to access more formal services, enhance their wellbeing and help tackle social isolation. Capacity building, co-production and the development of social capital are central to developing resilience. The role of the third sector is vital.

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Priority Prevention Themes (cross-cutting enablers) for new/additional action for the EP

Summary of comments generated through Edinburgh Partnership consultation 2014

E) Developing an enhanced Neighbourhood Focus (which includes improving the physical environment)

The importance of localities and neighbourhoods (at different levels/sizes) is clear. The ability to target interventions to be more responsive and generate higher levels of customer satisfaction and community engagement are all likely to enhance prevention. The physical environment of local areas is also increasingly recognised as important to wellbeing. There are major opportunities in the city in the coming year to explore the links between locality/neighbourhood working and prevention (e.g. building on existing Total Place and neighbourhood models).

F) Supporting People with Multiple and Complex Needs (Inclusive Edinburgh)

There is a need to improve service responses and outcomes for this vulnerable group of people who often live chaotic lifestyles and are affected by substance misuse, mental and physical ill-health, homelessness and domestic abuse. A wide ranging review to improve services for people with complex needs has been initiated in Edinburgh. Prevention in this context is about addressing the already complex needs of this group and helping to prevent further decline; it is also about stopping people reaching this stage, where possible.

G) Tackling Poverty (including child poverty, economic inequality and health inequalities)

Tackling poverty and related intractable issues, such as health inequalities are fundamental strands of a prevention approach, because of the serious effects they have on people’s lives, in the short and longer terms. The cost both to individuals and society is high – with a close link to ‘failure demand’. Edinburgh is increasingly understood as a dual city, with high levels of affluence, alongside persistent significant levels of poverty. The Edinburgh Partnership has brought a focus to addressing poverty and inequality through its Poverty and Inequality Partnership and Framework, and city partners will embed this over time. An updated city approach to addressing child poverty is now due, and will contribute to the early years, early intervention and wider prevention agendas.

The above issues are not for one part of the Edinburgh Partnership or for one outcome of the SOA, they are of relevance to all city partners and constituent

partnerships.

In addition to the ‘enabling’ themes identified above, respondents also suggested a number of policy areas where new or additional action could be focused

– these include alcohol and drugs; domestic abuse, employment and reducing reoffending.

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CONTACT FOR FURTHER INFORMATION

Michelle Miller, City of Edinburgh Council, Waverley Court, Edinburgh

michelle.miller@edinburgh.gov.uk

Louise Wright, Health and Social Care, City of Edinburgh Council, Waverley Court, Edinburgh

louise.wright@edinburgh.gov.uk

MEMBERS OF EDINBURGH PARTNERSHIP PREVENTION STRATEGY STEERING GROUP 2014

Chair: Michelle Miller Mike Brown Nick Croft

Wendy Dale Tom Galbraith

Stephen Gourlay Marna Green

Paul Hambleton Michelle Hughes

Linda Irvine Mike Penny Donny Scott Ella Simpson David White

Louise Wright

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ENDNOTES

i Edinburgh Partnership information: http://www.edinburgh.gov.uk/info/20133/community_planning/391/edinburgh_partnership ii Edinburgh Partnership Community Plan 2015-18: will be available from 04/15 via:

http://www.edinburgh.gov.uk/info/20133/community_planning/391/edinburgh_partnership iii Cosla/SG Definition: http://www.gov.scot/Resource/0040/00405037.doc

iv Climate Change (Scotland) Act – http://www.legislation.gov.uk/asp/2009/12/contents

v Sustainable Development Partnership -

http://www.edinburgh.gov.uk/info/20206/sustainable_development_and_fairtrade/1082/edinburgh_sustainable_development_partnership vi Independent Budget Review Group Report - http://www.gov.scot/About/Review/IndependentBudgetReview/Resources/final-report

vii Commission on the Future Delivery of Public Services – http://www.gov.scot/Publications/2011/06/27154527/0

viii Scottish Government response to Commission on Future Delivery of Public Services - http://www.gov.scot/Publications/2011/09/21104740/0

ix SOA guidance December 2012: http://www.gov.scot/Topics/Government/local-government/CP/SOA2012/SOA2012

x Audit Scotland Report Nov 2014: Community Planning - Turning Ambition into Action http://www.audit-

scotland.gov.uk/docs/central/2014/nr_141127_community_planning.pdf xi Background details available on request from louise.wright@edinburgh.gov.uk

xii Background details available on request from louise.wright@edinburgh.gov.uk