Scottish Borders Council

Agenda and minutes

Venue: Council Chamber, Council Headquarters, Newtown St Boswells

Contact: iris Bishop, 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 Jim Torrance, Mrs Jeanette McDiarmid, Mrs June Smyth, Mrs Clare Hepburn, Mrs Jenny Miller and Mrs Fiona Morrison.

 

The Chair confirmed the meeting was quorate.

 

The Chair welcomed Mrs Clare Smith and Ms Julie Watson to the meeting who were speaking to the Workforce Planning Framework item on the agenda.

 

The Chair welcomed and announced that Cllr Iain Gillespie had been formally appointed by Scottish Borders Council to the Health & Social Care Integration Joint Board in place of Cllr David Parker.

 

The Chair confirmed that the items 3 (Formal Appointment of Chief Officer) and 4 (Appointment of Interim Chief Financial Officer) on the agenda would be taken at the end of the meeting in a private session of the Health & Social Care Integration Joint Board.

 

2.

Formal Establishment of the Scottish Borders Health & Social Care Integration Joint Board pdf icon PDF 68 KB

Additional documents:

Minutes:

Mrs Susan Manion confirmed that the Health & Social Care Integration Joint Board was now legally established.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the legal establishment of the Scottish Borders Health & Social Care Integration Joint Board.

 

3.

DECLARATIONS OF INTEREST

Minutes:

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

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted none were declared.

 

4.

MINUTES OF PREVIOUS MEETING pdf icon PDF 128 KB

Monday 1 February 2016

Minutes:

The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 1 February 2016 were approved. 

 

5.

MATTERS ARISING pdf icon PDF 93 KB

Action Tracker

Minutes:

5.1         Minute 5: Health & Social Care Strategic Commissioning Plan:  Dr Eric Baijal confirmed that the population figures for Hawick and Galashiels had been checked and were accurate.

 

5.2         Action Tracker:  Mrs Susan Manion advised that the Development session timetable and subject matter for the Health & Social Care Integration Joint Board would be reviewed. 

 

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

 

6.

Code of Corporate Governance pdf icon PDF 58 KB

·         Standing Orders

·         Clinical & Care Governance

·         Risk Management Strategy

Additional documents:

Minutes:

Mrs Susan Manion gave an overview of the suite of documents that made up the Code of Corporate Governance for the Health & Social Care Integration Joint Board.  Each document was then discussed in turn.

 

In regard to the Local Code of Corporate Governance, Mrs Jill Stacey confirmed that the cover paper set out how the Board would measure itself and meet the key principles that would apply.

 

Mr David Davidson suggested reviewing the wording in terms of labels and titles as page 50 referred to the “Leader” and that was an incorrect terminology for the Health & Social Care Integration Joint Board.

 

Mr John McLaren sought clarification of a staff governance element to the code.  Mrs Manion advised that there were two outstanding items, one of which was staff governance and the other was patient public involvement, both of which were referred to in the Scheme of Integration.  Both elements would be included in the Code in future once the detail had been fully worked up and agreed.

 

Mrs Stacey suggested Principle 5 was the key element around staff governance and she reminded members that the document remained live and would change as the Health & Social Care Integration Joint Board evolved.

 

Mrs Manion advised that the Standing Orders element had been in place during the shadow period and were now submitted for formal approval.

 

Mrs Pat Alexander suggested revising the wording at Point 24 to include members of sub committees.

 

Mrs Manion suggested the Audit Committee Terms of Reference and formal appointment of members to that Committee would be brought to the next meeting of the Health & Social Care Integration Joint Board.

 

A discussion took place in regard to the Clinical and Care Governance Assurance Framework and several issues were raised including: the Health & Social Care Integration Joint Board receive a copy of the Health Board Clinical Governance reports and the equivalent Local Authority reports; the NHS Clinical Governance Committee expand its membership to include a member of the Health & Social Care Integration Joint Board;  NHS Clinical Governance Committee minutes be shared with the Health & Social Care Integration Joint Board; linking assurance to performance information/reports;

 

Mr John Raine cautioned against over complicating matters and was clear that there were governance processes in all organisations around the table and there was no need to duplicate those.  The requirement of the Health & Social Care Integration Joint Board was to be assured that good governance was in place in the organisations from which it commissioned services.

 

Mrs Manion agreed with the suggestions raised and advised that the next step was to work out a common approach and understanding in terms of providing an assurance for all the services within the delegated functions. 

 

Mrs Evelyn Rodger advised that she would work with Mrs Manion and Mrs Karen McNicoll on the wording of the document as the Healthcare Governance Steering Group referred to had been disbanded. 

 

Mrs Pat Alexander enquired how Scottish Borders Council received assurance in regard to the Arms Length Organisation, SB Cares.  ...  view the full minutes text for item 6.

7.

Health & Social Care Strategic Plan pdf icon PDF 71 KB

Additional documents:

Minutes:

Mrs Susan Manion gave an overview of the content of the document and the next steps to be taken.  Dr Eric Baijal reminded members that they had seen and commented on the document previously.

 

Mr John Raine confirmed that he was happy to support the approval of the strategic plan. 

 

The Chair thanked Dr Baijal and his team for developing the strategic plan and confirmed that the document was in essence what the Health & Social Care Integration Joint Board was all about and would in effect hold everyone to account for making improvements to the health and care of the people of the Scottish Borders.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD homologated the decision to approve the Health & Social Care Strategic Plan.

 

8.

Workforce Planning Framework pdf icon PDF 91 KB

Minutes:

Mrs Clare Smith gave an overview of the workforce planning framework and Mrs Julie Watson spoke of the people planning process within Scottish Borders Council and how both were taken into account and used to formulate a single plan for the Health & Social Care Integration Joint Board.  It was noted that both processes were very similar and the next step was to align the processes in terms of timescales.  It had been agreed to ensure both NHS Borders and Scottish Borders Council workforce plans would be in place by 30 June each year. 

 

A discussion ensued which focused on several elements including: linking to third sector partners; a challenge for staff in integrated services where terms and conditions vary; recognition of potential difficulties in regard to professional guidance for staff in integrated services; creative solutions for localities in regard to GP recruitment and locum cover; a strategic approach to recruitment; impact of living wage on low paid staffing groups; and workforce age profiling; sharing values based recruitment processes.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the Workforce Planning Framework report and the planned actions for 2016/17.

 

9.

Monitoring of the Integration Joint Budget 2015/16 pdf icon PDF 84 KB

Additional documents:

Minutes:

Mr Paul McMenamin detailed the content of the monitoring report of the shadow integrated budget advising of a projected pressure position of £403k overspent at the end of January 2016.  He detailed the pressure areas and mitigating actions that had been taken.  He confirmed that any year end overspends would be addressed by the responsible organisations.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the reported projected position of £403k net pressures at 31st January 2016 and noted that both partner organisations were working to minimise any adverse variance at year-end but should that not be possible the responsible organisation would ensure that resources were available to ensure a break even out turn.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted that Budget Holders/Managers would continue to work to deliver planned savings and deliver a balanced budget.  Where that was not possible managers would work to bring forward actions to mitigate any projected overspends.

 

10.

Health & Social Care Integration Integrated Resources Advisory Group pdf icon PDF 124 KB

Additional documents:

Minutes:

Mr Paul McMenamin gave a detailed overview of progress made to establish the financial governance arrangements for the partnership as well as the proposed way forward.

 

Mr John Raine commented that the compliance assessment to date report, was a report approved by the Interim Chief Financial Officer and the Financial Statement for 2016/17 was complete and to be approved by the Health & Social Care Integration Joint Board in March and accompanied by a due diligence report.  He enquired if the due diligence report as contained within the appendices and if it was contradicted by the Chief Officer’s report that suggested the Interim Chief Financial Officer and the Chief Officer could not recommend acceptance of the draft budget until such time as the efficiency gap for the Health Board had been resolved.

 

Mr McMenamin confirmed that there was an anomaly as the report had been written with the full expectation that a fully funded report would be presented for approval.  It became apparent late on in the process that a fully funded report would not be received.  Work continued to develop a finally agreed position in terms of forecasts and the due diligence of the sufficiency of resources. 

 

Mr Raine enquired if the due diligence report was available.  Mr McMenamin advised that the report was drafted and the assurance report reflected the due diligence process.  The final due diligence report would be submitted to the Health & Social Care Integration Joint Board for their consideration. 

 

Mr Raine enquired of the status of other Health & Social Care Integration Joint Boards across Scotland in regard to determining and accepting their budgets.  Mrs Manion advised that a number of other Health & Social Care Integration Joint Boards were meeting in March to agree their budgets. 

 

Mrs Susan Manion advised that on reflection the recommendation had been amended in order to provide the Health & Social Care Integration Joint Board with an update in relation to the financial arrangements and the expectation that the budget required resolution by end of March.

 

Cllr John Mitchell commented that he was delighted the Health & Social Care Integration Joint Board was deemed VAT neutral.

 

The Chair sought clarification that the compliance check document would be resubmitted to the Health & Social Care Integration Joint Board as completed.  Mr McMenamin confirmed that that would.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the progress made to date in the development and implementation of the key financial arrangements following recommended best practice and compliance with legislation which required to be in place prior to 1 April 2016 and beyond and agreed the plan of actions for the remaining work requiring completion and approval.

 

11.

Financial Statement (supporting the Strategic Plan) and Assurance over the Sufficiency of Resources pdf icon PDF 146 KB

Additional documents:

Minutes:

Mrs Susan Manion gave an overview of the content of the report.  She highlighted several key elements including: draft budgets to be delegated and summary of delegated functions; highlighting the set aside budget; financial risks of resources available to it and the mitigation that had taken place; due diligence; base line; understanding of existing and evidenced emerging pressures; and planned efficiencies.  Mrs Manion was keen to stress she was absolutely clear of the intent to complete the planned efficiencies work across the systems to ensure there were plans in place through the NHS in order to be able to provide assurance to the Health & Social Care Integration Joint Board on the sufficiency of resources. 

 

Mrs Manion further highlighted that Scottish Borders Council had agreed its efficiencies and the NHS given their later national timeframe had been unable to confirm their efficiencies to date.  She suggested further work would be undertaken on the financial statement and the accompanying due diligence report and both would be submitted to the next meeting.

 

A discussion ensued that focus on several matters including: caveats in place until a settled financial position for the NHS is reached; £5m for development and refinement of Health & Social Care Integration Joint Board services;  further guidance on the £5m to be issued by Scottish Government; double counting of £5.2 sitting in baseline budget for both Scottish Borders Council and NHS Borders; and the Health & Social Care Integration Joint Board would direct Scottish Borders Council through written directions how to use the £5.2m.

 

Mr David Robertson quoted from the John Swinney letter to all Council Leaders and advised that he would share the letter with Health & Social Care Integration Joint Board members.

 

Cllr John Mitchell enquired how the financial figure was arrived at for the NHS.  Mr McMenamin confirmed that it was a calculated share of NHS Borders financial budget for 2016/17 as at present and a determination of set aside.  Mrs Carol Gillie expanded on the explanation and advised that legislation and guidance defined which services were set aside.  She advised she would happy to provide Cllr Mitchell with more detail outwith the meeting. 

 

In regard to efficiency savings Mr John Raine recognised that the Health & Social Care Integration Joint Board needed to be assured on the affordability of the functions delegated to it.  He advised that the NHS dealt with efficiency savings each year by tasking senior staff and others including Board members to find efficiency savings during the course of the financial year.  He advised that NHS Borders was required to make £11m savings in 2016/17 and was not at present in a position to identify in detail how those savings would be achieved.

 

Mrs Manion highlighted the differences between the two organizations processes in dealing with financial gaps and savings targets.  She clarified that there were ongoing discussions within the NHS about the level of efficiencies and where they could be achieved and where the headline figures were.  She reiterated that the NHS was complex in terms  ...  view the full minutes text for item 11.

12.

Chief Officer's Report pdf icon PDF 83 KB

Additional documents:

Minutes:

Mr David Davidson suggested the report should contain more detail and timelines.  The Chair echoed Mr Davidson’s request.

 

The Chair advised that the next Development session for the Health & Social Care Integration Joint Board was identified as 23 May and she proposed that it be a full day taking the Board out into the region.  She asked Board members to alter their diaries accordingly.

 

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

 

13.

Committee Minutes pdf icon PDF 69 KB

Additional documents:

Minutes:

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

 

14.

ANY OTHER BUSINESS

Minutes:

14.1     SB Cares:  Mrs Elaine Torrance sought a member of the Health & Social Care Integration Joint Board to become a member of the SB Cares Governance Committee.  Mrs Torrance was asked to circulate the Terms of Reference for the Committee.  It was noted that Cllrs Renton and Mitchell were already members of the Group and a member from the NHS membership of the Health & Social Care Integration Joint Board would be welcomed.

 

14.2     Extraordinary Meeting:  It was agreed that an Extraordinary meeting of the Health & Social Care Integration Joint be called before the end of March to focus solely on the Financial Sufficiency of Resources.  The Board Secretary was tasked with identifying a suitable date. 

 

15.

DATE AND TIME OF NEXT MEETING

Monday 18 April 2016 at 2.00 pm in Committee Room 2, Scottish Borders Council

Minutes:

The Chair confirmed that the next meeting of the Health & Social Care Integration Joint Board would take place on Monday 18 April 2016 at 2.00pm in Committee Room 2, Scottish Borders Council.

 

 

CONTACT US

Scottish Borders Council

Council Headquarters Newtown St. Boswells Melrose TD6 0SA

Tel: 0300 100 1800

Email:

For more Contact Details