Agenda and minutes

Apologies had been received from Mr John Raine, Mr David Davidson, Mr M Leys, Mrs L Gallacher and Dr Cliff Sharp. 

The Chair welcomed Mr Tris Taylor as a voting member of the Integration Joint Board.  Mr Taylor was a Non Executive of NHS Borders.

The Chair confirmed the meeting was quorate.

The Chair welcomed Mr Philip Lunts and Mr Simon Burt 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 no verbal Declarations of Interest.

26 June 2017

The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 26 June 2017 were approved. 

Action Tracker

4.1          Minute 20.2: Prof John Bolton:  Mrs Angela Trueman enquired about progress.  Mrs Elaine Torrance commented that a lead person was to be identified and then the working group would be set up.  She advised that the working group would be made as inclusive as possible.

4.2          Action 13: LIVE Borders:  Mrs Elaine Torrance advised that she had met with Mr Euan Jackson who had offered to provide a presentation to a future meeting of the Integration Joint Board.  Mrs Tracey Logan welcomed the suggestion given the progress that had been made in regard to various initiatives to address diabetes such as, direct access to sport facilities, and prescriptions for fitness.

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

Mrs Elaine Torrance gave an update on the current status of items of interest to the Integration Joint Board, and highlighted: publication of annual performance report; launch of locality plans; draft commissioning and implementation plan; regional collaboration in the South East between Chief Officers and themes formulated, such as mental health, diabetes, workforce and sharing best practice.

Mrs Torrance advised the Board of the recruitment timeline for the Chief Officer Health & Social Care appointment and also advised that Mr Paul McMenamin was keen to conclude his appointment as Interim Chief Financial Officer to the Integration Joint Board.  An agreement had been reached between NHS Borders and Scottish Borders Council to put in place a seconded interim arrangement whilst a recruitment process was formulated.

Mrs Angela Trueman enquired if the full locality plans were available in hard copy.  Mrs Torrance advised that the summary documents were available from libraries and health centres with full copies available on line. 

Further discussion focused on: feedback on the locality plans format – more detail required – under representation of groups – not enough on mental health in some areas; refresh of the workforce development plan; areas of collaboration for recruitment; consultation and engagement process for the locality plans; south eastern regional collaboration between local authorities, health boards and integration joint boards; and process for the appointment of a new Chief Officer and Interim Chief Financial Officer to the Integration Joint Board.

The Chair was keen that the Integration Joint Board was seen to be involved in the selection of the Chief Officer and Chief Financial Officer appointments.   Mrs Jane Davidson confirmed that both the Chair and Vice Chair of the Integration Joint Board would be members of the interview panels for the appointments.

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

Presentation

Mr James Lamb spoke to a presentation providing information on background, progress to date, resources required and efficiencies.

Mr John McLaren sought assurance that the right people were being invited to be involved in the on-going and future work.  Mrs Elaine Torrance commented that a session was being organised to bring together all the managers with a communication brief being formulated and key stakeholders being invited along.

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

Mrs Elaine Torrance gave an overview of the content of the paper and focused the attention of the Board on several key elements including: funding amounts in the future and how much had been committed to date; uncommitted funding and proposals utilise that to move forward with the transformation work and improve the pathway for people through the hospital and back to their homes; projects and spend to date; evaluation work; £10 being realised for every £1 invested in community capacity building; community hubs; and the transitional care facility at Waverley Care Home. 

Cllr Shona Haslam enquired about the Community Capability teams.  Mrs Torrance commented that they were funded through the Integrated Care Fund (ICF), which was a time limited fund set up specifically to allow test of change initiatives.  It was anticipated that the projects supported through the ICF would be mainstreamed at the end of the funding if appropriate. 

Cllr Haslam enquired about the timescales for the Community Capacity team initiative.  Mrs Torrance advised that the project was due to conclude in March 2018 and she would ensure the next ICF report listed the timescales of each of the current funded projects and their proposed exit strategies.

Further discussion included: success of the “men shed” initiative; bringing the elderly out of social isolation; walking netball; healthcare support worker service 7 day a week, 12 hour day pilot; inclusion of baseline benchmark figures and percentages in future reports; conclusion of locality coordinators contracts in September and the provision of a single extended appointment to take on the planning and delivery of the locality areas; and fuller reports to be produced for schemes seeking additional funding.

Dr Angus McVean commented that there appeared to be further bids for funding from the ICF however he was under the impression the fund had been closed to further bids.  Mrs Torrance reported that the ICF had been closed to bids.  She advised that the further bids listed were actually pieces of work to be commissioned that would assist the transformation programme to address the key priority of delayed discharges.  Mrs Jane Davidson commented that the bid fitted with the Buurtzorg approach of testing and agreeing integrated working.   

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD requested that future ICF reports containing schemes requiring further funding contained, baseline figures, outcomes, evaluation and impact on patients, to allow a considered decision to be taken.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the current expenditure position of the ICF and the progress of key projects. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD ratified proposals for further ICF funding (£10,500 Matching Unit and Health Care Support Workers £51,999 in Berwickshire). 

Presentation (attached)

Mr Philip Lunts presented the Joint Winter Plan 2017/18 to the Board.  He highlighted the lessons learnt from the previous years’ winter plan; areas of work and progress to date.

Mrs Jenny Smith commented on the support available through volunteers in communities and enquired if there were plans to work more closely with the Red Cross over the festive period.  Mr Lunts confirmed that discussions would be taking place with the Red Cross during September.  Mrs Smith highlighted that the provision of services for home to hospital, basic supplies and shopping were all important during the winter period.

Further discussion focused on: agency spend and the staffing of surge beds during the winter period; recruitment to anticipated vacancies; value of social work and community services input to the winter plan; focus on reducing admissions; access to home care; and re-ablement approach; identify and make care packages simpler; and re-emphasis care staff career paths.

Mrs Karen Hamilton enquired why it was so difficult to achieve a greater proportion of morning discharges.  Mr Lunts commented that there were a series of things that needed to happen before someone could be discharged and it was a challenge to align those groups of staff and items to achieve early discharge.  However the intention was to now move those awaiting discharge to the discharge lounge to refocus attention on that patient awaiting discharge. 

Cllr Helen Laing acknowledged that the reduction in cancelled surgery the previous year appeared to be a success.  She queried however if it had been an anomaly.  Mrs Jane Davidson commented that it had been a direct reflection of not having to cope with norovirus.  Mr Lunts further commented that the introduction of the Acute Assessment Unit had also enabled patients to be processed better.   

Cllr Tom Weatherston enquired if staff were offered enhanced pay rates to cover staff shortages.  Mrs Claire Pearce advised that all NHS staff were bound by national terms and conditions under Agenda for Change, however if full time staff worked over their 37.5 hours a week they were entitled to time and half pay. 

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

Mr Simon Burt gave an overview of the content of the mental health strategy and advised that it had been developed in line with relevant national strategies and the local strategic plan which provided a focus for the future direction of the service.

Cllr Shona Haslam enquired about the audience for the strategy.  Mr Burt confirmed it was a public document.

Cllr Haslam enquired of the Children and Adults Mental Health Service (CAMHS) timetable, when the working group would be established.  Mrs Torrance advised that the working group had been set up and the current service would continue until something different was commissioned.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the mental health strategy.

Mrs Elaine Torrance gave an update on the current status of the inspection report.  She advised that initial feedback had been received from the Care Inspectorate and Health Improvement Scotland.  A substantial number of amendments to the draft report had been submitted and a meeting had been held with both organisations.  The next draft of the report was awaited as well as notification of the formal publication date.

Mrs Torrance also advised that an action plan had been drawn up as she was aware that there would be some actions to address from the report.

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

Mrs Elaine Torrance presented the Terms of the Reference to the Board. 

Discussion focused on: 2 year rotation of the Chair and Vice Chair; number of meetings; terms of reference for the Strategic Planning Group; terms of reference for the Public Partnership Forum and how it feeds into the Integration Joint Board or Strategic Planning Group; updating the communication and engagement plan;

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD considered the report and approved the proposed Terms of Reference, subject to the inclusion of a 2 year rotation of the Chair and Vice Chair and amending the scheduled meetings to be six per year.

Mr Paul McMenamin provided an overview of the content of the paper and highlighted: Large Hospital Budget Set-Aside; Borders Ability & Equipment Service; monitoring position; further direction of social care funding; and mitigation and recovery plan.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the report and the monitoring position on the partnerships 2016/17 revenue budget at 30 June 2017.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved recommendations for further direction of social care funding (specifically £407k Older People Residential Care, £100k Housing with Care, £200k Adults with Learning Disabilities).

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD asked the Chief Officer to bring forward a plan for the delivery of remedial savings to address the shortfall attributable to the part-year only impact of the Integrated Transformation Programme in 2017/18.

The Chair recorded the thanks of the Integration Joint Board to Mr Paul McMenamin for his input and support to the Board over the previous 18 months.

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

14.1     Development Session:  Mrs Elaine Torrance reminded the Board that the next development session would be held on Monday 25 September and would focus on the Commissioning and Implementation Plan as well as Pharmacy Development and Prescribing Pressures.

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

14.2     Newsletter:  Mrs Elaine Torrance tabled a copy of Issue 6 of the Health & Social Care newsletter which was aimed at all stakeholders, third sector and the public and would be released electronically in due course.

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

14.3     IJB Audit Committee:  Mrs Jill Stacey circulated the Internal Audit report from the Development session held earlier that day.  She sought agreement from the Board to amend the Audit Committee Terms of Reference to reflect the rotation period for the Chair & Vice Chair of the Integration Joint Board. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed the amendment to the Audit Committee Terms of Reference.

Monday 23 October 2017 at 2.00pm in the Committee Room 2, Scottish Borders Council

The Chair confirmed that the next meeting of Health & Social Care Integration Joint Board would take place on Monday 23 October 2017 at 2.00pm in Committee Room 2, Scottish Borders Council.