Scottish Borders Council

Agenda and minutes

Venue: Committee Room 2, Council Headquarters, Newtown St Boswells

Contact: Iris Bishop, NHS Board Secretary  Tel: 01896 825525 Email:  iris.bishop@borders.scot.nhs.uk

Items
No. Item

1.

ANNOUNCEMENTS & APOLOGIES

Minutes:

Apologies had been received from Cllr Catriona Bhatia, Cllr Jim Torrance, Cllr Iain Gillespie, Mrs Tracey Logan, Dr Eric Baijal, Mrs June Smyth, Mrs Julie Murray, Ms Sandra Campbell, Mr Alasdair Pattinson, Mr John McLaren, Mrs Shona Donaldson, Mr Stewart Barrie and Ms Gwyneth Johnston. 

 

The Chair confirmed the meeting was not quorate. 

 

The meeting agreed to discuss and note the items on the agenda and noted it would be unable to approve any recommendations.  The Chief Officer proposed the ability of the Health and Social Care Integration Joint Board to remit items to the Chair or Chief Officer to approve.  This was rejected as it was not in line with the standing orders.

 

The Chair welcomed a range of attendees to the meeting including Mrs Shelagh Martin from the Scottish Health Council and Mrs Lynn Crombie from SB Cares.

 

The Chair welcomed members of the public to the meeting.

 

 

2.

DECLARATIONS OF INTEREST

Minutes:

The Chair sought any verbal declarations of interest pertaining to items on the agenda.

 

Mr David Davidson declared that in regard to the item on Integrated Care Fund Update, he was the Chair of two independent charity organisations.   

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted Mr Davidson’s declaration.

 

3.

MINUTES OF PREVIOUS MEETING pdf icon PDF 221 KB

Monday 20 June 2016

Minutes:

The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 20 June 2016 were amended at page 2, last line replace “fulsome” with “fuller” and page 4 last paragraph, first line replace “Patient” with “Public” and with those amendments the minutes were noted and would be held over for approval at the next meeting. 

 

4.

MATTERS ARISING pdf icon PDF 90 KB

Action Tracker

Minutes:

4.1         Action 1: Draft Strategic Plan:  It was suggested that the session on Commissioning be held sooner rather than later.

 

4.2         Action 6: Inspection of Adult Services:  It was noted that Item 6 was now complete as the session had been held earlier that day.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the action tracker.

 

 

5.

GP Contract Update and Cluster Approach pdf icon PDF 129 KB

General Manager Primary & Community Services

Additional documents:

Minutes:

Dr Angus McVean gave an overview of the content of the paper and highlighted: a move to a four cluster approach; demographics; appointment of quality cluster leads; appointment of practice quality leads; and funding of the quality leads.

 

Dr Stephen Mather enquired how the Practice and Cluster Quality Lead appointments would be resourced.  Dr McVean advised it would be for the Health & Social Care Integration Joint Board to provide the resource.  Mrs Susan Manion commented that the specific decision making was a matter for the Health Board as the contractor for GP services, however resources for primary care funding to support GPs had been provided as part of the functions delegated and therefore sat within the delegated budget.

 

Dr McVean advised that he understood that the Practice Quality Leads would be funded from the primary care budget however the Quality Cluster Leads might not be. 

 

Mrs Manion advised that funding currently flowed from the Health Board to GPs through the Health & Social Care Integration Joint Board and the next step would be to identify what was required and what was approved and then understand the implications and whether it could be funded from another source.

 

Dr Mather commented that it appeared the assumption was that the Health Board would be funding the posts and he asked for assurance that the appointment process would be robust as the posts were essentially becoming lead positions.  He further enquired if the appointees would become Health Board employees.  Mrs Manion responded that she understood that the current process was to employ and then agree how funded and she would continue with that approach.

 

Dr Mather requested that the recruitment and appointment and funding of the quality lead posts be reviewed and brought back to the Board for further discussion.

 

Mr Andrew Murray enquired about the next steps.  Dr McVean advised that the legislation passed to GPs was that GP Practices would agree the cluster approach to be taken locally.  Discussion had taken place at the Local Medical Committee (LMC) where the preferred option had been to have 4 locality clusters and the LMC were settled on that position.  In regard to the cluster quality leads the LMC were clear that a robust interview and appointment process was required to ensure the right person was appointed with the right experience and ability to speak for and to the constituent GP practices. 

 

Mrs Jane Davidson commented that the matter was yet to be discussed by and with the Health Board, including the engagement with the LMC.  She was aware of informal engagement taking place but reminded the Health and Social Care Integration Joint Board that the Health Board was the contractual agent with GPs and required to understand and discuss with the LMC their proposal.

 

Mrs Manion commented on the need to be supportive and work with GPs and in relation to locality plans.  She suggested it was a good compromise to ensure it was local and offered opportunities to think about across the health and  ...  view the full minutes text for item 5.

6.

Integrated Care Fund Update pdf icon PDF 132 KB

Interim Chief Financial Officer

Additional documents:

Minutes:

Mr Paul McMenamin provided an overview of the Integrated Care Fund (ICF) programme spend position at 30 June 2016, as well as an overview of the latest position for budget approval and development of the programme.  He confirmed that there were 19 projects that had been approved by the Steering Group with a further 5 projects identified for approval.  The total value of all approved projects amounted to £2.41m. 

 

Mrs Jane Robertson gave an overview of the five new projects: development of locality plans; locality management; health and social care coordination; community led support; and the matching unit.  

 

In regard to the projects recommended to the Health and Social Care Integration Joint Board (IJB) for approval, Mr John Raine sought assurance from the Executive Management Team (EMT) that the projects were sustainable and would assist the achievement of the aims of the IJB, given the EMT was the route for recommendations to the IJB. 

 

Mrs Susan Manion contradicted the minutes of the previous meeting in regard to the approval route for ICF projects and stated that in terms of the process the ICF Steering Group and the Chief Officer approved the projects, the EMT considered and reviewed specific proposals with an oversight to ensure delivery and then recommended to the IJB.  She was keen to revisit the approval process again and commented that at each stage of the process the ICF Steering Group carefully monitored the application against the outcomes and drew the Board’s attention to Appendix 2 and 3 of the paper which she suggested provided the assurance required.

 

Mr John Raine pointed out that in the minutes of the last meeting Mrs Jeanette McDiarmid had clearly stated that the Executive Management Team would provide the IJB with assurance to the recommendations submitted to it against the Strategic Plan.  Mrs McDiarmid confirmed that the EMT went through each project in detail in order to be able to provide that assurance to the IJB and suggested that it be more clearly referred to within future reports. 

 

Dr Stephen Mather commented that he failed to see how “development of locality plans” and “locality management” actually improved services for the patients, he suggested both initiatives looked at changes to the way things were managed.  In regard to the other 3 projects he could see a direct correlation to improvements in patient care and patient access.  He suggested that to state redesign was a key priority was incorrect as the key priority should be the most important things for patients. 

 

Mr Paul McMenamin suggested his terminology could be reviewed and whilst he agreed that projects 1 and 2 were not key priorities to the patient, all the stakeholders he had engaged with saw service redesign as a priority to enable them to achieve their outcomes.  

 

Mrs Manion advised that the locality coordinators were crucial to the development of the locality plans and she emphasised that it was short term funding to set up the new arrangements. 

 

Mr David Davidson noted the engagement  ...  view the full minutes text for item 6.

7.

Prescribing Efficiencies pdf icon PDF 108 KB

Director of Pharmacy

Additional documents:

Minutes:

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD deferred the item to the next meeting.    

 

8.

Performance Management Framework pdf icon PDF 62 KB

Chief Officer

Additional documents:

Minutes:

Mrs Susan Manion introduced the proposed performance management framework and advised that she was seeking comments on the format and content.  She acknowledged the significant amount of work that had been undertaken by Mrs Stephanie Errington and Mrs Gillian Young in producing the draft framework.

 

Dr Stephen Mather noted there was a duplication of item 18 on page 7.  Mrs Elaine Torrance suggested adult protection be included.  The Chair suggested the colours be changed to lighter tones.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the further development of the Performance Management Framework and noted a revised version would be submitted to the next meeting. 

 

9.

Health & Social Care Public Governance Arrangements pdf icon PDF 68 KB

Chief Officer

Additional documents:

Minutes:

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD deferred the item to the next meeting as it required consideration by the Public Partnership Forum, the Public Governance Committee of NHS Borders, inclusion of a quorum, inclusion of conflict resolution process, and inclusion of social care.

 

10.

Monitoring of the Health and Social Care Partnership Budget 2016/17 pdf icon PDF 169 KB

Interim Chief Financial Officer

Additional documents:

Minutes:

Mr Paul McMenamin gave an overview of the content of the report and highlighted that it was a purely factual report and that actions were being taken to address the actions the report raised.

 

Mr David Robertson commented that the report was due to be submitted to the SBC Executive meeting the following day and he said that he would inform them that as the IJB meeting was inquorate no decisions on the content of the report could be made.

 

Mrs Jane Davidson suggested she would have expected, given the various overspends in health, that the report would have referred to the activation of Section 8 of the Scheme of Integration around financial recovery plans, especially given the level of overspend on NHS unscheduled care services. 

 

Mrs Susan Manion advised that in the first instance the paper detailed the current financial monitoring position.  She suggested a second issue was the process by which the social care fund would be accessed and allocated based on the content of the John Swinney letter and to address the pressures within the Health Board.  She commented that the social care fund would not address all the pressures across all the agencies.

 

The third issue related to how overspends and pressures would be dealt with.  She commented that discussions would take place with colleagues in the Health Board around recovery plans and scrutinising efficiency plans.

 

The Chair made further suggestions that the use of the social care fund be worked up taking into consideration the pressures in both SBC and NHS Borders to ensure a joined up partnership approach was taken to allow the IJB to make a fully informed decision.  She suggested a recovery plan be submitted to the IJB for the whole of the budget.

 

Mr McMenamin advised that since the 30 June further considerable pressures had emerged across the wider delegated budget.  He commented that in GP prescribing the financial pressure had significantly increased in recent months.  Mr McMenamin further advised that in his professional judgement, whilst he did not quote Section 8 of the Scheme of Integration, his report did refer to working in partnership to address the financial position.

 

Mr John Raine commented that whilst the IJB was unable to make a decision at that time on the £1.427m social care fund, any decision taken in isolation from all other pressures would be a problem for the IJB in the future as there were considerable budget pressures across both partner organisations.

 

Mrs Manion suggested there was an explicit expectation of how the social care fund would be spent and that the IJB had already agreed an element of that spend.  She commented that consideration and agreement in principle had been reached regarding spend on the flex beds within the Health Board, but she urged the IJB to be mindful that the allocation of the social care fund needed to be in line with the expectations of the Scottish Government.

 

Mrs Elaine Torrance commented that a lot of additionality was  ...  view the full minutes text for item 10.

11.

Chief Officer's Report pdf icon PDF 68 KB

Chief Officer

Additional documents:

Minutes:

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the report.

 

12.

Delayed Discharges pdf icon PDF 77 KB

Chief Officer

Additional documents:

Minutes:

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the presentation.

 

13.

Awayday Evaluation 23.05.16 pdf icon PDF 157 KB

Chief Officer

Minutes:

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the evaluation would be withdrawn from the meeting agenda and submitted to the next Development session.

 

14.

DATE AND TIME OF NEXT MEETING

Monday 17 October 2016 at 2.00pm in Committee Room 2, Scottish Borders Council

Minutes:

The Chair confirmed that an Extra Ordinary meeting of the Health & Social Care Integration Joint Board would be arranged.

 

 

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