The neighbourhood approach has been really helpful to us in resource mapping. We know that the resource mapping will probably show that, in some rural areas, particularly areas such as Arran, we spend disproportionate amounts in relation to the population.
North Ayrshire is like many other parts of Scotland in that we have a huge variation in need. In Largs on the north coast and on Arran, we have large elderly populations, with people who live into their 80s or 90s and who basically need health and social care services in their later years. However, in Irvine and the three towns people die 20 years earlier than those in Largs and the north coast—Glasgow has exactly the same challenges in a far more compact geographical area. Those people become sick in their early 40s and 50s.
That is the challenge that we face, and it is reflected in the work that Laura Friel talked about on needs. Our strategic plan for health and social care has a needs strategy underneath it, which has been developed by NHS Ayrshire and Arran and which looks at some of the issues that we have on emergency admissions and outcomes for vulnerable children. We have agreed that those are the priority areas.
We will begin to look at how we address the neighbourhood issue in the strategic plan, which will be available in its first draft within the next month. The plan will set out how we will spend the £200 million that the council and health board have delegated into the partnership, as well as how we will spend the £2.9 million of integration funding that the Government has made available.
We will set that out, but we will not be able to answer all the questions. In year 1, we will probably have more questions than answers, but we will define what we will prioritise in relation to mental health, older people, learning disability, children’s services and criminal justice services; what our redesign projects will be; and how we will integrate the health and social care responses in those areas. We will make better use of the resources that we have.
The elephant in the room is that demand for social care and health services is increasing. Particularly for social work, we need the universal services to take up prevention and early intervention initiatives, which is what we have been working on in North Ayrshire. What can health and education services do that begins to prevent some of the traffic towards social work?
We have more children in care, more children on the child protection register and more elderly people in nursing homes than we have ever had before. I am in charge of mental health services for the whole of Ayrshire and Arran. We have seen a huge increase in the number of people who are acutely ill coming into hospital services and who require one, two, three or four members of staff to deal with them. The issues that we face in providing services are causing real strain.
NHS Ayrshire and Arran has some of the highest figures for emergency admissions to hospital, which is why we have prioritised emergency admissions. A lot of the money is tied up there, but it will not be easy to get it out and move it into community services, although we need to attempt to do that. We are also looking at the outcomes for vulnerable children.
We are considering what we should do and we are looking to use the resource that we have in the best possible way, integrating it across partnerships, so that we—by which I mean health and social work—deliver for children alongside education and the police, and so that health and social work delivers for adults and older people in the community alongside the voluntary sector, in particular.
We can do a lot to look at how we use the resource. We have got better at that, but at the end of the day demand is still increasing. We see the impact of the recession every day, which is why employment is the most important issue in North Ayrshire. We know that having a job is what has the biggest impact on a person’s health—and we have lost more jobs in North Ayrshire than many other local authorities have lost. We see the impact of welfare reform, too, particularly when people lose their benefits. We see the impact of that on vulnerable populations.
We have to cope with all of those issues, as well as moving the money. We are trying to move the money that we can move, but it is a challenge, because we still have to admit people to hospital and take children into care, while providing nursing care placements and care at home and looking after people who have mental ill health. That is the balancing game that we are playing.