Health and Wellbeing Outcomes

People live happy and healthy lives with a healthy life expectancy.

People who need care are supported to live independently and confidently.

Positive end of life.

How do children's services affect these outcomes?

Early intervention in childhood can help reduce physical and mental health problems across the lifespan. Children services contribute to these outcomes by, for example:

• Early learning and childcare provides a focus on outdoor learning, exercise and play to promote physical and mental health
• Education for all children provided via Curriculum for Excellence promotes and teaches emotional resilience, self-esteem and interpersonal skills that can protect against risks relating to social disadvantage, family disruption and other diversity in life and mental illness. Priority is also given to increasing physical activity in schools recognising the benefits it provides for both physical and mental health.
• Supporting vulnerable children and young people who are looked after.  These children are frequently from backgrounds of deprivation, poor parenting, abuse and neglect, and often risk a worse level of health than their peers.  They are more likely to experience speech and language problems, bedwetting, co-ordination difficulties and eye-sight problems. Councils have invested significantly in services for looked after children to support prevention and earlier intervention to improve outcomes for children who are looked after, whether they are in residential care, looked after by kinship carers or foster carers, looked after at home, adopted, or leaving care.

Children's services indicators and descriptions

• CHN1: Cost per primary school pupil
• CHN2: Cost per secondary school pupil
• CHN3: Cost per pre-school education place
• CHN4: Percentage of pupils gaining 5+ awards at level 5
• CHN5: Percentage of pupils gaining 5+ awards at level 6
• CHN6: Percentage of pupils living in the 20% most deprived areas gaining 5+ awards at level 5
• CHN7: Percentage of pupils living in the 20% most deprived areas gaining 5+ awards at level 6
• CHN8a: The gross cost of 'children looked after' in residential based services per child per week
• CHN8b: The gross cost of 'children looked after' in a community setting per child per week
• CHN9: Balance of care for 'looked after children': % of children being looked after in the community
• CHN10: Percentage of adults satisfied with local schools
• CHN11: Percentage of pupils entering positive destinations
• CHN12a: Overall average total tariff
• CHN12b: Average total tariff SIMD quintile 1
• CHN12c: Average total tariff SIMD quintile 2
• CHN12d: Average total tariff SIMD quintile 3
• CHN12e: Average total tariff SIMD quintile 4
• CHN12f: Average total tariff SIMD quintile 5
• CHN13a: % of P1, P4 and P7 pupils combined achieving expected CFE level in literacy
• CHN13b: % of P1, P4 and P7 pupils combined achieving expected CFE level in numeracy
• CHN14a: Literacy attainment gap (P1,4,7 combined) - percentage point gap between the least deprived and most deprived pupils
• CHN14b: Numeracy attainment gap (P1,4,7 combined) - percentage point gap between the least deprived and most deprived pupils
• CHN17: Percentage of children meeting developmental milestones
• CHN18: Percentage of funded early years provision whihc is graded good/better
• CHN19a: School attendance rates
• CHN19b: School attendance rates
• CHN20a: School exclusion rates (per 1,000 pupils)
• CHN20b: School exclusion rates (per 1,000 'looked after children')
• CHN21: Participation rate for 16-19 year olds (per 100)
• CHN22: Percentage of child protection re-registrations within 18 months
• CHN23: Percentage LAC with more than 1 placement in the last year (Aug-July)

Health and Wellbeing Outcomes

People live happy and healthy lives with a healthy life expectancy.

People who need care are supported to live independently and confidently.

Positive end of life.

How do adult social care services affect these outcomes?

Health and wellbeing is dependent on individuals receiving the support they need to live an independent life.  It is recognised that health disadvantage starts before birth and accumulates through life.  Adult social services support better health and wellbeing outcomes by for example;

• Councils provide care assessments for adults to identify risks to an individual's independent living or health and wellbeing and ensure appropriate packages of care are available to meet the needs identified.  By providing services to those who need it the most, local authorities will help address health inequalities. The care and support available ranges from advice and information about options and financial support available, care at home, residential or nursing care, and support for carers.
• Councils support those eligible for social care to exert more control and choice over the support they receive via Self Directed Support. This enables service users to choose services that suit and improve their lifestyle, control their support at the level that works best for them, and provides more choice and flexibility.
• Care at home services may be in the form of ongoing support to promote independent living at home, or may be arranged to support a safe return home after a stay in hospital (re-ablement).  It may involve the following support:
  • personal and nursing care (personal hygiene; continence management; food and diet; immobility problems; counselling and support; simple medication/dressing treatments; personal assistance e.g. with dressing/getting in and out of bed; nursing care involves administering injections or managing pressure sores.
  • general cleaning, heavy housework and gardening
  • shopping
  • meals on wheels or frozen meals delivery
  • collecting pensions and prescriptions
  • paying bills
  • laundry, like washing and ironing in your home or a laundrette
  • equipment and adaptions like telecare and home improvements to help older adults remain mobile, independent and safe in their own homes
  • care and repair services
  • day care centres that offer an opportunity to socialise in the community, do activities not available in the home and provide skills that promote independence
  • energy assistance to provide help paying fuel bills or keeping an affordably warm home.
  • transport advice on a range of options to help older adults get help with travel to continue to access activities and services they need
  • access to physiotherapy and occupational therapy
  • preventing falls at hom
  • supported or sheltered housing to support older people to live independently, in a smaller and easier-to-manage home with accessibility features, and with the reassurance of having someone to call on if there's an emergency.
  • dementia services including intimate personal care as the ability for self-care declines, increasing levels of supervision, emotional support, decision-making, behaviour changes, coping with the risks to safety, personality changes and changes within the relationship.
  • support for carers, including short breaks, also called respite care
• Residential care homes offer personal care when care needs cannot be met in an individual's own home, and as a result, they are at risk
• Nursing care homes offer similar facilities to residential care homes, with the additional support of qualified nurses who can assist if the individual requires nursing care on a frequent basis.

Adult social care indicators and descriptions

• SW1: Home care costs per hour for people aged 65 or over
• SW2: SDS spend on adults 18+ as a % of total social work spend on adults 18+
• SW3: Percentage of people aged 65 or over with intensive needs receiving care at home
• SW4a: Percentage of adults receiving any care or support who rate it as excellent or good
• SW4b: Percentage of adults supported at home who agree their services and support had an impact in improving or maintaining their quality of life
• SW4c: Percentage of adults supported at home who agree that they are supported to live as independently as possible
• SW4d: Percentage of adults supported at home who agree that they had a say in how their help, care or support was provided
• SW4e: Percentage of carers who feel supported to continue in their caring role
• SW5: Residential costs per week per resident for people aged 65 or over
• SW6: Rate of readmission to hospital within 28 days per 1,000 discharges
• SW7: Proportion of care services graded 'good' (4) or better in Care Inspectorate inspections
• SW8: Number of days people spend in hospital when they are ready to be discharged, per 1,000 population (75+)

Health and Wellbeing Outcomes

People live happy and healthy lives with a healthy life expectancy.

People who need care are supported to live independently and confidently.

Positive end of life.

How do corporate services affect these outcomes?

Corporate services directly and indirectly improve the health and well-being of their local communities both through the council’s role as an employer and through their role in providing services to the local community.

In the community:

• Efficiencies within corporate services can release money for other services, such as education and culture and leisure, which are known to improve the health and well-being of the local communities. For example, access to well-kept local parks encourages people to walk more.
• Corporate services lead on transformation within councils and support the re-design of services that better meet the needs of users. For example, online library services, such as e-books, may make it easier for people who are house-bound or who have long commutes to access library services.
• Through well-designed procurement processes, corporate support enables the release of community benefits and employment opportunities for local people, particularly apprenticeships.
• Corporate services lead on compliance including equalities and health & safety, which means that all local people have the same opportunities to access services regardless of their gender, ethnicity or disability and that council buildings are safe to use.

As an employer, corporate services:

• Provide good quality and well-designed employment opportunities for local people.
• Provide good maternity and paternity policies enable parents to build bonds with their young children.
• Offer well-designed corporate HR policies and accompanying IT, that enables staff to work flexibly and remotely, which can lead to better work-life balance and support staff with caring responsibilities. This is both good for member of staff but also for their family and wider community.
• Offer good training opportunities so that their staff can develop their practice.
• Recognise unions which enables employees to have a say.

Corporate services indicators and descriptions

• CORP 1: Support services as a % of total gross expenditure
• CORP 3b: Percentage of the highest paid 5% employees who are women
• CORP 3c: The gender pay gap (%)
• CORP 4: The cost per dwelling of collecting council tax
• CORP 6a: Sickness absence days per teacher
• CORP 6b: Sickness absence days per employee (non-teacher)
• CORP 7: Percentage of income due from council tax received by the end of the year
• CORP 8: Percentage of invoices sampled that were paid within 30 days

Health and Wellbeing Outcomes

People live happy and healthy lives with a healthy life expectancy.

People who need care are supported to live independently and confidently.

Positive end of life.

How do culture and leisure services affect these outcomes?

Participation in sports, culture and outdoor spaces have a positive effect on both physical and mental health and wellbeing. Culture and leisure services contribute to these outcomes by, for example:

• Regular attendance culture and leisure services result in positive social connections which is a key factor in positive health and wellbeing
• Older adults who exercise exhibit better cognitive function which helps them to stay independent for longer.  They also have higher overall levels of functional health and lower risk of falling.
• Regular exercise reduces all-cause mortality and disease, tackles the obesity epidemic, cardiovascular disease, diabetes, high blood pressure, stroke and cancer.
• Participation in exercise has a positive effect on mental health problems including anxiety, depression, mood and emotion.  It also promotes self-esteem and psychological function
• Leisure centres provide a range of targeted services for older people, including fall prevention schemes to minimise time in hospital due to falls and activities such as walking groups to prevent social isolation
• Libraries and Museums provide courses and groups tailored to promote the health and wellbeing of vulnerable groups, to help promote inclusion, stimulate learning and improve cognitive function.
• Culture can improve mental wellbeing.  Cultural prescribing adopts a holistic approach to tackling mental health and wellbeing issues, addressing the impact of social, economic and cultural factors on mental health. Approaches including meditation; Painting, Cookery, Arts & crafts, Creative writing & poetry and a reading group have been shown to reduce symptoms of depression and anxiety. Greater participation in the arts and engaging with learning opportunities provided by libraries and museums has also been shown to increase confidence and wellbeing
• Green spaces support improved physical health by providing no-cost opportunities for sports, walking, cycling, gardening and conservatory work.
• An increase in exposure to green space leads to reduction in terms of expected health problems.  The proportion of green and open space is linked to self-reported levels of health and mental health for all ages and socio-economic groups. Living in areas with green spaces is associated with significantly less income-related health inequality, weakening the effect of deprivation on health.
• Green spaces provide places to meet friends and neighbours that flourishes mental health and wellbeing. They also offer an opportunity for quiet and contemplation and a focus for communal activity and community pride. Involvement in the process of improving greenspaces and local neighbourhoods can be particularly beneficial for those at risk of developing mental health problems
• Aspects of greenspace that may reduce stress include: outdoor activity and exercise; natural daylight; stimulation of the senses (sight, sound, scent, temperature, touch, balance and hearing); and, aesthetic experience. In relation to physical activity outcomes and the use of greenspace, the key influences are the distance, ease of access, size, connectivity, attractiveness and amenities. Greenspace has the potential to increase physical activity by both providing an attractive area to exercise in independently and the opportunity to undertake group-based physical activity with other people (Croucher et al, 2007).

Culture and leisure indicators and descriptions

• C&L1: Cost per attendance at sports facilities
• C&L2: Cost per library visit
• C&L3: Cost of museums per visit
• C&L4: Cost of parks & open spaces per 1,000 population
• C&L5a: Percentage of adults satisfied with libraries
• C&L5b: Percentage of adults satisfied with parks and open spaces
• C&L5c: Percentage of adults satisfied with museums and galleries
• C&L5d: Percentage of adults satisfied with leisure facilities

Health and Wellbeing Outcomes

People live happy and healthy lives with a healthy life expectancy.

People who need care are supported to live independently and confidently.

Positive end of life.

How do environmental services affect these outcomes?

Living in a community that is safe and clean and have well developed transport networks is linked to mental and physical wellbeing. Environmental services enable these outcomes by, for example:

• Ensuring a healthy and save living environment for residents, including street cleansing and waste services, food safety (licences); pollution; private water supplies; public health nuisances (noise; dirty houses/gardens; dog issues; fly tipping; litter; graffiti)
• Air and land pollution can affect people's health in a number of ways. Short-term effects include upper respiratory infections such as pneumonia and bronchitis; long-term effects include lung and heart diseases. Air pollution can also aggravate existing conditions such as asthma and emphysema.
• Poor waste disposal practices lead to the accumulation of harmful substances and create a breeding ground for bacterial diseases.
• Providing street lighting and safe footway networks
• Improving the quality of roads and pathways to reduce falls and accidents
• Implementing Green transport strategies which promote greater active travel
• Consumer protection helping to protect citizens from scams and fraud
• Supporting local businesses to pursue circular economy opportunities (reduce, re-use and recycle) which helps to minimise waste, has positive social impact and reduces consumption and associated carbon impacts
• The sale and distribution of energy creates the potential to reduce energy poverty. Furthermore, it is an opportunity to protect council residents and businesses against significant energy price increases and provide a step change in carbon reduction initiatives
• Protecting the rich environmental heritage of Scotland's landscapes and biodiversity by preventing waste in water bodies that affect all ecosystems existing in the water and preventing hazardous chemicals that get into soil which harm plants.

Environmental services indicators and descriptions

• ENV1a: Net cost of waste collection per premise
• ENV2a: Net cost of waste disposal per premise
• ENV3a: Net cost of street cleaning per 1,000 population
• ENV3c: Street Cleanliness Score
• ENV4a: Cost of maintenance per kilometre of roads
• ENV4b: Percentage of A Class roads that should be considered for maintenance treatment
• ENV4c: Percentage of B Class roads that should be considered for maintenance treatment
• ENV4d: Percentage of C Class roads that should be considered for maintenance treatment
• ENV4b: Percentage of U Class roads that should be considered for maintenance treatment
• ENV5a: Cost of Trading Standards, Money Advice & Citizen Advice per 1,000 population
• ENV5b: Cost of environmental health per 1,000 population
• ENV6: Percentage of total household waste arising that is recycled
• ENV7a: Percentage of adults satisfied with refuse collection
• ENV7b: Percentage of adults satisfied with street cleaning

Health and Wellbeing Outcomes

People live happy and healthy lives with a healthy life expectancy.

People who need care are supported to live independently and confidently.

Positive end of life.

How do housing services affect these outcomes?

Stable and safe housing is directly linked to physical and mental health in both children and adults. Housing services contribute to these outcomes by for example;

• Councils have a legal duty to assess and respond to housing need for their area.  Councils also have specific legal requirements to tackle sub-standard housing and homelessness
• Well-designed housing, including adaptions, modernisation and improvements, and effective repairs services promote health and wellbeing.  Thermally efficient housing reduces the likelihood of cold related death or illness.  Living in poor housing creates a disproportionately greater risk of poorer general health, low mental wellbeing and respiratory problems. People living in dwellings that are damp, cold or mouldy are at greater risk of respiratory conditions, meningococcal infection, and asthma.  Poor housing conditions have a long-term impact on health, increasing the risk of severe ill-health or disability by up to 25 percent during childhood and early adulthood. One of three adults who grow up in overcrowded housing have respiratory problems in adulthood. Children living in damp, mouldy homes are between one and a half and three times more likely to coughing and wheezing.

Housing indicators and descriptions

• HSN1b: Gross rent arrears (all tenants) as at 31 March each year as a percentage of rent due for the reporting year
• HSN2: Percentage of rent due in the year that was lost due to voids
• HSN3: Percentage of council dwellings meeting Scottish Housing Standards
• HSN4b: Average number of days taken to complete non-emergency repairs
• HSN5: Percentage of council dwellings that are energy efficient

Health and Wellbeing Outcomes

People live happy and healthy lives with a healthy life expectancy.

People who need care are supported to live independently and confidently.

Positive end of life.

How do economic development and planning services affect these outcomes?

Health and wellbeing is closely linked to the level of deprivation communities experience. Economic development and planning services contribute improving health and wellbeing outcomes by, for example:

• Providing services to encourage economic growth and employment
• Supporting the development of thriving local businesses that enable adults to access the services they need in their local area to promote health and wellbeing.  This includes supporting a thriving and sustainable local market for the provision of social care services for, including the development of community led approaches, and increasing use of social/micro enterprises
• Neighbourhood planning that promotes healthier lifestyles, with appropriate housing, access, transport, local services and amenities
• Strategic planning to deliver the quantity and type of housing (and associated services) required to meet demographic projections in relation to the growing numbers of over 65's, over 75's and over 85's.

Economic development and planning indicators and descriptions

• ECON1: Percentage of unemployed people assisted into work from council operated / funded employability programmes
• ECON2: Cost per planning application
• ECON3: Average time per business and industry planning application (weeks)
• ECON4: Percentage of procurement spent on local small / medium enterprises
• ECON5: No of business gateway start-ups per 10,000 population