Agenda and minutes

Apologies had been received from Cllr Graham Garvie, Mrs Pat Alexander, Dr Stephen Mather, Mrs Jenny Smith, Ms Lynn Gallacher, Dr Angus McVean, Mrs Jill Stacey, Mrs Jane Davidson, Mrs Tracey Logan and Dr Annabel Howell.

The Chair confirmed the meeting was quorate.

The Chair recorded the thanks of the Board to Cllr Jim Torrance and Cllr Iain Gillespie who had stepped down from the Board.  The Chair welcomed the appointments of Cllr Sandy Aitchison and Cllr Graham Garvie to the Board.

The Chair welcomed a range of attendees to the meeting.

The Chair welcomed members of the public to the meeting.

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

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

Monday 20 June 2016

Monday 15 August 2016

The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 20 June 2016 were approved.

The minutes of the Extra Ordinary Health & Social Care Integration Joint Board meeting held on 15 August 2016 were approved.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed that a future development session would consider the relationship between the sub groups of the Health & Social Care Integration Joint Board, the Scottish Borders Council and NHS Borders to ensure connections were made and that there was clarity as to the separate roles.

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

Interim Chief Financial Officer

Mrs Susan Manion highlighted some key points being: agreements reached so far in relation to projects; projects to be progressed in support of the Implementation Plan; mapping against outcomes and investment; and locality plans and developing resources.  She further touched on Locality Management, Community Led Support and the Matching Unit.

The Chair suggested going through each of the five projects in turn and taking questions.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved theDelivery of the Localities Plan Project.

In regard to the Locality Management Pilot, Mr John McLaren expressed his anxiety on how the pilot would be progressed given the differences in staff engagement processes within both parent bodies.  Mrs Jeanette McDiarmid noted the concern and confirmed that the local authority would engage with the unions at the start of the pilot and prior to any implementation.  Mrs Carol Gillie advised that she and Mrs McDiarmid would ensure due process was followed in order to address Mr McLaren concerns. 

The Chair suggested any feedback and learning from Mr McLaren around the process would potentially be useful for the future.

Mrs Elaine Torrance reminded the Board of the linkages to the Joint Staff Forum and suggested all of the projects would be of interest to the Joint Staff Forum.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the Locality Management Pilot. 

In regard to the Health & Social Care Coordination Project, Mrs Manion advised that the project was linked to the Locality Management pilot in the sense that it was the implementation of the implementation plan for models of care, she clarified it was about individuals taking responsibility for essentially holding the strings on a number of patients pathways to ensure they were followed. 

Mrs Evelyn Rodger whilst supportive of the principles of locality managers, was keen to understand how much of the resources had gone in to support managers.  She suggested it would be helpful to have that mapped out, in order to be clear on what was available, what had been delivered and what might be needed in the future.  The Chair further commented that it should also include release of funding from other areas to support that moving forward.

Mr McLaren questioned the sustainability of continuity of service if it related to one individual.  He further queried how realistic, one year was in order to be able to demonstrate delivery against the objectives in the plan.  Mrs Manion confirmed that the intention was to put 2 to 3 items together to make it as robust and sustainable and systemic as possible and not just reliant on individuals. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the Health & Social Care Coordination Project. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the Community Led Support Project. 

In relation to the Matching Unit Project, Cllr Sandy Aitchison enquired if the £115k contained all of the expenditure for staff, etc.  Mrs Manion confirmed that the infrastructure already existed and the project was about social workers moving to a brokerage for placements  ...  view the full minutes text for item 5.

Interim Chief Financial Officer

Mr Paul McMenamin gave a brief presentation highlighting the emergence of budgetary pressures during July and early August; risks to the overall deliverable ability of a balanced budget outturn in relation to pressures emerging in year; how the budget was funded through efficiencies and other savings plans in the partner organisations; social care funding; the monitoring position; and self directed support funding.

Mr David Davidson thanked Mr McMenamin for his realistic overview of the current position and where the Board was headed financially.  He suggested documentation be produced to indicate the risks to the budget being sustainable at current levels and where savings might be made and what could be ceased in order to afford the budget.  He further commented that whilst the partnership had ambitions, there were significant financial challenges and ideally, the partnership should consider a reserve. This would need to be agreed across the partner agencies.  He further suggested that the Board should ensure that what was proposed to be delivered was achievable within budget and that officers be tasked with making a 2.5% saving on budgets before any investment in future projects was agreed.

The Chair suggested a separate discussion be scheduled in regard to the provision of a reserve.

Mr David Robertson commented that in regard to the COSLA discussions with the Scottish Government it had been clearly expressed that the aspirations on the living wage were not fully funded and the assumption was that 25% of the costs would be met by the Care Providers and would not be passed back to the Local Authorities.  However in reality, Care Providers were renewing contracts and passing the costs (living wage, National Insurance, etc) back to the commissioners.  He commented that whilst the Scottish Government had provided funding to pay for services, the pressures within Scottish Borders Council were a direct result of implementing Government policy.  He also suggested a reserve was a sensible strategy to pursue, however in order to establish a reserve the budget would need to be underspent which was currently not feasible. 

The Chair advised the Board that it had the authority to direct the two partner organisations to look at how they would address the financial implications coming forward and to give direction to them on the actions it wished them to take on the emerging pressures.

Mr Robertson cautioned that funding was not a defence against the equalities challenge and legal requirements.

Mrs Carol Gillie welcomed Mr McMenamin’s clear presentation and reiterated that the emerging pressures would impact on each organisation unless addressed and resolved jointly. 

Mr John McLaren requested that Mr McMenamin provide his presentation to the next meeting of the Joint Staff Forum.  Mr McMenamin advised that he would be content to provide the presentation to the Joint Staff Forum.

Mrs Elaine Torrance suggested a joint communication strategy be worked up to highlight the challenges and plan how to advise the Joint Staff Forum, wider staff and the public.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the  ...  view the full minutes text for item 6.

7.1       Audit Committee Membership:  The Chair advised that Cllr Gillespie had been nominated as a member of the Audit Committee and she proposed that Cllr Graham Garvie replace him as a member.  Cllr Frances Renton seconded the proposal. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD duly noted Cllr Graham Garvie as a member of the Audit Committee.

7.2       Development Session:  The Chair advised that she had invited Geoff Huggins, Director of Health & Social Care Integration, Scottish Government to speak to the Board at its Development session on 26 September.  It was expected that discussion would focus on the national perspective and where integration was on a national basis and the pressures that were emerging and any advice he might have for the Board on managing those pressures.

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

The Chair confirmed that the next meeting of the Health & Social Care Integration Joint Board would be held on Monday 17 October at 2.00pm in Committee Room 2, Scottish Borders Council.