Scottish Borders Council

Agenda and minutes

Venue: Committee Room 2, Scottish Borders Council

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

Items
No. Item

1.

ANNOUNCEMENTS AND APOLOGIES

Minutes:

Apologies had been received from Mrs Karen Hamilton, Mrs Jane Davidson, Mr John McLaren, Cllr John Greenwell and Mrs Tracey Logan. 

 

The Chair confirmed the meeting was quorate.

 

The Chair welcomed Mr Asif Haseeb from Audit Scotland, Mrs Yvonne Chappell, who was deputising for Mr John McLaren, and Mr Peter Lerpiniere who was deputising for Mrs Claire Pearce.

 

The Chair welcomed members of the public to the meeting.

 

2.

Integration Joint Board Nomination of Vice Chair

Minutes:

The Chair advised that under the terms of the Scheme of Integration the Chair and Vice Chair roles would alternate on an annual basis between the NHS and the Council voting members on the Board.  As the Chair of the Integration Joint Board for 2017/18 was handed across to the NHS there was a requirement for a Councillor to fulfill the Vice Chair role. 

 

Cllr Shona Haslam nominated Cllr David Parker as Vice Chair of the Integration Joint Board.

Mr John Raine seconded the nomination.

 

Cllr David Parker accepted the nomination.

 

The Chair announced that Cllr David Parker was duly elected as the Vice Chair of the Integration Joint Board.

 

 

3.

Integration Joint Board Audit Committee Membership

Minutes:

The Chair announced that it had been agreed by the Integration Joint Board voting members, via email, that Cllr Tom Weatherston and Cllr John Greenwell be nominated as the local authority members of the Integration Joint Board Audit Committee.  He asked that the voting members of the Board confirm they were content with those nominations. 

 

The Health & Social Care Integration Joint Board confirmed its approval of the nominations.

 

The Chair further advised that the Audit Committee had met that morning and proposed that Cllr Weatherston would be the Chair of the Audit Committee.  He asked that the voting members of the Board confirm they were content with that nomination. 

 

The Health & Social Care Integration Joint Board confirmed its approval of the nomination.

 

4.

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 there were no verbal declarations of interests.

 

5.

MINUTES OF PREVIOUS MEETING pdf icon PDF 177 KB

27 March 2017

Minutes:

The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 27 March 2017 were amended at page 4, item 8, paragraph 2, line 4 replace “Patient” with “Participation” and again at page 6, item 13, paragraph 2, line 4 delete “by up to 80%” and with those amendments the minutes were approved. 

 

6.

MATTERS ARISING pdf icon PDF 88 KB

Action Tracker

Minutes:

6.1         Action 14:  The Health &Social Care Integration Joint Board reviewed and agreed that the action was complete.

 

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

 

7.

CHIEF OFFICER'S REPORT

Minutes:

Mrs Elaine Torrance gave an update on the current status of items of interest to the Integration Joint Board including: presentation of the Internal Audit Report to the Audit Committee that morning; the proposal that the Integration Joint Board undertaken a self evaluation at a future Development session; completion of the Annual Performance Report; progress with the transformation programme; progress with the Joint Workforce Plan; and work on the Information Technology (IT) systems to work together.  She further advised that she had attended one day of the NHS Scotland Event which had focused on health and social care integration and working together to move that forward.

 

Mr David Davidson enquired about how the IT development would be conducted.  Mrs Torrance confirmed that both NHS Borders and Scottish Borders Council were looking at which systems they operated that were the same, which systems could be linked and how they could streamline systems for all staff.

 

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

 

8.

Transformation & Efficiencies pdf icon PDF 97 KB

Report by Chief Officer.

Additional documents:

Minutes:

Mrs Elaine Torrance introduced Mr James Lamb who gave an update on current progress.  He advised that 10 projects had been identified and spoke of the timelines and content associated with each project.  

 

Mrs Jenny Smith sought clarification that the Equality and Diversity Impact Assessments for each individual project would be completed as part of the strategic planning process.  Mr Lamb confirmed that was correct.

 

Mrs Smith sought more detail on the single management structure and its potential impact on the third sector.  Mr Simon Burt commented that whilst some exploratory work had been undertaken in regard to the alcohol and drugs service it was unlikely that a single management structure would be put in place.  Attention was being focused on the potential for co-location and joint working. 

 

Further discussion highlighted: further detail on project outcomes; the interpretation of “reimagining”; and timescales and achievement of savings targets.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the progress made in developing the Transformation and Efficiencies Programme.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD endorsed the development of identified workstreams. 

 

9.

Learning Disabilities Strategic Commissioning Plan pdf icon PDF 91 KB

Report by Chief Officer.

Additional documents:

Minutes:

Mr Simon Burt gave an overview of the learning disabilities service remit and the content of the paper which provided information for stakeholders regarding commissioning arrangements and future plans of the Scottish Borders Learning Disability Service (2016-2019).  Mr Burt further highlighted Project SEARCH and advocacy services.

 

Cllr Helen Laing enquired about the provision of accommodation outside the area and the impact on the patient, family and friends.  Mr Burt commented that it was an issue across all health and social care partnerships.  In Scottish Borders there were no longer in-patient hospital assessment treatment units, so the provision was sourced from other Health Boards and then the private sector.  Discussions were on-going with NHS Lothian about the purchase of beds from their Learning Disabilities Service.  In regard to people with challenging behaviours, some independent provision was provided locally and discussions were taking place with East Lothian about the possibility of commissioning something together. 

 

Mr John Raine reminded the Integration Joint Board (IJB) that the functions of the learning disabilities service resided with the IJB and the budget was provided by both NHS Borders and Scottish Borders Council for the IJB to commission services.  He sought assurance that if the IJB adopted the Learning Disability Strategic Commissioning Plan it would be commissioned for the improvements the IJB wished to see at a strategic and operational level.  Mr Burt confirmed such assurance.

 

Further discussion focused on: repatriation of individuals back to Scottish Borders where appropriate; delivery of adult protection through services and providers; commissioning of safe services; criteria scoring; and potential for an increase in the number of contacts with the service.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the report and adopted as the first commissioning plan from the IJB. 

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD recorded its thanks to Mrs Susan Henderson and Mr Simon Burt for producing such a comprehensive document. 

 

 

10.

Integrated Care Fund Update pdf icon PDF 155 KB

Report by Chief Officer.

Additional documents:

Minutes:

Mrs Elaine Torrance gave an overview of the content of the paper and advised that to date a total of £1.548m had been spent.  She suggested the partnership programme team contracts be extended at a cost of £125k and that £52k be granted to the Buurtzorg initiative. 

 

Further discussion focused on: pump priming shifts in delivery of care; favouring the front line ahead of administration services; seeking a demonstration of how change had been brought about from NHS Borders and Scottish Borders Council as a consequence of funding the initiatives/projects; matching unit beginning to deliver and matches clients to homecare providers having been assessed as needing home care and the aim was to reduce care manager time; community led support project is successful in seeing people quickly, waiting lists are reducing, and customer satisfaction is good; Waverley has been successful and work continues to roll out the admissions criteria to other sites; 72% of patients return to their original home after being discharged from hospital to Waverley.

 

Mr David Davidson enquired about influencing commercial bus routes and their timetables and how appointments were made for outpatients to make it easier for patients to get to appointments.  Cllr Shona Haslam commented that she had met with bus operators the previous week and they would be rolling out a new ticketing system and monitoring where accessibility issues were on the network to ensure those who needed buses could get them. 

 

Mrs Torrance suggested an update on the transport hub could be provided at a future meeting.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the position of the Integrated Care Fund. 

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD ratified the 2 new funding requests, Partnership Programme Team (£125k) and Buurtzorg (£52k). 

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted progress on key projects.

 

11.

Primary Care Funding - Pharmacists in GP Practices pdf icon PDF 126 KB

Report by Director of Pharmacy.

Minutes:

Mrs Alison Wilson gave an overview of the content of the paper. 

 

Mr David Davidson enquired about training programmes and Mrs Wilson commented that training programmes were organised by NHS National Education Scotland and support was provided by pharmacy practices as mentors for the prescribing qualification.  

 

Cllr Helen Laing enquired if the training was similar to nurse practitioner training.  Mrs Wilson confirmed that it was a similar course and there were some similarities. 

 

The Chair enquired if a person went to their pharmacist and got a prescription, if that prescription was routinely shared with the individuals’ GP practice.  Mrs Wilson advised that it was not.

 

Dr Angus McVean commented that it was not ideal and a single unitary system would be preferred.  He suggested that the GP community broadly welcomed and supported the initiative.

 

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

 

 

12.

Quarterly Performance Report pdf icon PDF 90 KB

Report by Chief Officer.

Additional documents:

Minutes:

Mrs Elaine Torrance gave a brief overview of the content of the report and highlighted several key elements including: carers’ data; rates of emergency admissions had reduced; delayed discharges; and palliative care. 

 

Cllr Helen Laing enquired if contact for the over 75s to provide support and prevent admissions could be more creative, by visiting or surveying, involving them in the new Buurtzorg initiative, so that some kind of assessment was undertaken as a preventive measure to reduce over 75s admissions.

 

Dr Angus McVean suggested that may not work as much of the preventative packages and measures that used to be undertaken had ceased as the majority did not show a difference in admission rates. 

 

Mr Murray Leys suggested the key to supporting people was anticipatory care planning.

 

The Chair commented that delayed discharges were quite emotive and they were actually stranded patients in the wrong place.  He suggested seeking data to provide a picture of what happened to people who stayed in hospital too long.

 

Mr Leys advised that he could provide some raw data to show the destinations of delayed discharges, those who lost function and were reassessed and those who were returned home.

 

Mr John Raine suggested individualised and anonymised case studies could be provided to show, individuals on the patient journey, their destinations, when they became delayed discharges, for how long and why, and their final outcome.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the additional themes and measures for report.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the key performance issues highlighted.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD advised of any further measures to be included in future quality performance reports.

 

 

13.

Health & Social Care Locality Plans pdf icon PDF 131 KB

Report by Chief Officer.

Additional documents:

Minutes:

Mrs Elaine Torrance presented the locality plans and area profiles and sought a two month period of consultation of the plans beginning in July.  She advised that the final plans would be submitted to the IJB in September following the consultation period. 

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the progress made by Locality Co-ordinators in relation to the development of the H&SC Locality Plans.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD endorsed the plans and proposals for consultation.

 

 

14.

Inspections Update

Minutes:

Mr Murray Leys advised that the draft report had been received from the Care Inspectorate and was being checked for factual accuracy.  The final report and publication date were awaited.

 

The Chair confirmed that some of the comments in the draft report had been inaccurate and that had been fed back to the Care Inspectorate.  Mr Leys confirmed that was the case.

 

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

 

 

15.

Annual Report 2016/17 pdf icon PDF 22 KB

Report by Chief Officer.

Additional documents:

Minutes:

Mrs Elaine Torrance presented the Annual Report 2016/17.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the Annual Report 2016/17.

 

16.

Annual Performance Report of IJB 2016/17 pdf icon PDF 83 KB

Report by Chief Officer.

Additional documents:

Minutes:

Mrs Elaine Torrance gave an overview of the content of the annual performance report and highlighted that it set out the key priorities and direction of travel for the partnership for the coming year. 

 

Mrs Jenny Smith commented that she was content to endorse the report and she asked that the report for 2017/18 be shared with third sector colleagues earlier in the process so that they could provide more meaningful input and feedback. 

 

The Chair commented that within the Executive Summary it would be helpful to set out both areas of good and poor performance.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the Annual Performance Report.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD endorsed proposals for publication of the report.

 

 

17.

Report on the refresh of partners financial regulations across the partnership resources

Minutes:

Mr Paul McMenamin provided an update on partnership regulations.  He reminded the IJB that its Audit Committee had asked that it issue a direction to partners to refresh their financial regulations.  He confirmed that NHS Borders financial regulations had been updated in October 2016 and Scottish Borders Council financial regulations had been updated in August 2016.  The refreshes were undertaken in the context of both organisations recognising their relationship with the IJB at that time.  Scottish Borders Council would be revising their financial regulations further in order to reflect the revised performance arrangements within the IJB.

 

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

 

 

18.

Financial Plan Update pdf icon PDF 245 KB

Report by Interim Chief Financial Officer.

Additional documents:

Minutes:

Mr Paul McMenamin reminded the IJB that on 27 March 2017 it approved the partnership budget for 2017/18.  He commented that the enabling report was extensive and set out a range of areas including key funding principles. 

 

Mr McMenamin reminded the IJB that resources were delegated from the partners to the IJB who commissioned back to the partners for the delivery of services. 

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the report and the Health & Social Care Financial Statement 2017/18 to 2019/20.

 

 

19.

Committee Minutes pdf icon PDF 33 KB

Additional documents:

Minutes:

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

 

20.

Any Other Business

Minutes:

20.1     Development Session:  Mrs Elaine Torrance reminded the IJB that the next Development session would be held on 25 September 2017 and would focus on two areas being, the commissioning and implementation plan, and pharmacy development and prescribing pressures.

 

The Chair suggested it was a timely opportunity given the IJB had new members to take another look at its role and responsibilities.

 

The HEALTH & SOCIAL CARE INTERGRATION JOINT BOARD agreed to hold a development session at 12noon, with lunch on 28 August to review its role and responsibilities.

 

20.2     Prof John Bolton:  Mrs Angela Trueman enquired about the session organised for September on the Prof John Bolton work.  Mrs Torrance commented that it would focus on developing out of hospital care and a presentation would be given on what had been achieved to date, tracking people out of hospital and making sure they did not return as admissions, and reductions in individual’s packages of care as they became better.  She further commented that Prof Bolton had agreed to be a critical friend to the partnership.

 

Mrs Trueman commented that at the meeting held on 4 April, Prof Bolton had mentioned a working group being formulated and she enquired if that had been organised and if a member of the public could be a member of that group?  Mrs Jenny Smith also enquired if a carer representative could also be a member of that group?  Mrs Torrance advised that she would find out and advise outwith the meeting.

 

 

21.

DATE AND TIME OF NEXT MEETING

Monday 28 August 2017 at 2.00pm in Committee Room 2, Scottish Borders Council.

Minutes:

The Chair confirmed that the next meeting of Health & Social Care Integration Joint Board would take place on Monday 28 August 2017 at 2.00pm in Committee Room 2, Scottish Borders Council. 

 

The meeting concluded at 3.40pm

 

 

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