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 & APOLOGIES

Minutes:

 

Apologies had been received from Cllr Shona Haslam, Mr John Raine, Dr Angus McVean, Ms Lynn Gallacher, Ms Susan Swan, Mrs Jane Davidson, Mrs Tracey Logan, Mrs Carol Gillie and Mr John McLaren.

 

The Chair confirmed the meeting was quorate.

 

The Chair welcomed Mrs Debbie Rutherford who was deputising for Mrs Lynn Gallacher and Mr Philip Barr who was deputising for Mrs Tracey Logan.

 

The Chair welcomed members of the public to the meeting.

2.

DECLARATIONS OF INTEREST

Members should declare any financial and non-financial interest they have in the items of business for consideration, identifying the relevant agenda item and the nature of their 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 none.

3.

MINUTES OF PREVIOUS MEETING pdf icon PDF 190 KB

18 December 2018

Minutes:

 

The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 18 December 2017 were amended at page 5, paragraph 4, line 2, delete “(set up by acute and primary care colleagues)” and replace with “by the partnership organisations”, and with that amendment the minutes were approved.

4.

MATTERS ARISING pdf icon PDF 92 KB

Action Tracker

Minutes:

4.1       Minute 7: Appointment of Chief Financial Officer: Mrs Karen Hamilton enquired of the outcome of the Chair’s consideration of writing to the Cabinet Secretary. The Chair advised that he had considered the matter and had decided given an internal resolution was underway he would not be writing to the Cabinet Secretary.

 

4.2       Minute 6: Inspection: Joint Older People’s Services Report: The Chair noted that there was an expectation that the Joint Older People’s Services Report was likely to change. Mr Murray Leys confirmed that a meeting with the Care Inspectorate had been held and they were currently reviewing the improvement plan that had been submitted. Work continued to progress on the improvement plan even though formal feedback was awaited. Mr Colin McGrath sought a copy of the full improvement plan and evidence of progress. Mr Leys and Mr Robert McCulloch-Graham confirmed that the Board had previously received the full improvement plan which contained all the evidence gathered and the intention was to bring a final report to the Board once formal feedback from the Care Inspectorate had been received. They also confirmed that the documentation was available in the public domain.

 

4.3       Action Tracker: It was agreed that historic scheduling dates should be included in the progress box on the action tracker.

 

5.

CHIEF OFFICER'S REPORT pdf icon PDF 125 KB

Minutes:

Mr Robert McCulloch-Graham gave an overview of the content of the report and highlighted: the pressures on systems over the winter period; the opening of the Craw Wood facility and the turnover of patients within the facility and potential expansion of that facility; progress with hospital to home across the region; difficulties with private guardianship orders; piloting the opening of some GP surgeries over 4 weekends; regional work; GP Quality clusters; Strategic Plan; Leadership Team training; performance/finance group progress and a delay with the recruitment to the Chief Financial Officer post.

 

Cllr John Greenwell enquired if there would be an opportunity to look at the Andrew Lang Unit under the Mental Health Transformation programme. Dr Cliff Sharp confirmed that the unit required consideration in terms of the estate as well as a potential possibility of a co-location of all childrens services, both health and social care, into one place.

 

Cllr David Parker enquired why the GP Saturday surgeries pilot had not encompassed the central Borders area. Mr McCulloch-Graham advised that it had been an optional pilot for GP practices. Dr Cliff Sharp confirmed that a similar pilot had been tried in Lanarkshire and had worked successfully, and from the feedback received there had been lessons learned locally. He commented that in preparation for next year the initiative would be planned further ahead with specific Saturdays identified and potentially GP surgeries targeted for opening.

 

Mr Tris Taylor wished to pass on thanks to the staff involved in progressing the Craw Wood initiative.

 

Cllr Helen Laing enquired if there was an opportunity to include welfare rights within the GP surgeries. Mr McCulloch-Graham confirmed that welfare rights was offered in the community hubs and it was for GPs to make referrals to the hubs.

 

Further discussion highlighted: role of GPs in moving to locality hub models; Quality Cluster leads; refresh of the strategic plan; provision of 10 reablement step down beds within Waverley for a maximum of 6 week periods; impact of Craw Wood and Waverley on reducing the need for surge beds in the acute setting; and resolution to the delay in advertising the Chief Financial Officer post.

 

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

 

6.

Inspections Update

Minutes:

Mr Murray Leys advised the Board that all of the recommendations within the Joint Older People’s Services report had been responded to. In regard to adult protection services, he had been tasked by the Critical Services Oversight Group (CSOG) to deliver a public protection service across the whole of Scottish Borders to ensure similar processes and procedures across systems were in place and to ensure the most vulnerable across the Borders were secure and safe. Work was currently underway to formulate a public protection service and overarching governance group with current representation from the Integration Joint Board via the Chief Officer.

 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the update and agreed to receive a presentation on the Public Protection Service at a Development session later in the year.

 

7.

The Integration Joint Budget 2017/18 pdf icon PDF 180 KB

Additional documents:

Minutes:

Mr Robert McCulloch-Graham gave an overview of the content of the report.

Mr David Davidson enquired about the potential to review the continuation or withdrawal of funding and grants to various charitable bodies and whether there was likely to be any further national funding made available.

 

Mr McCulloch-Graham clarified that there were a number of projects within the Integrated Care Fund that were due to conclude at the end of March, except for the Community Capacity Team project that the Board agreed to extend the funding for at the last meeting. There was an intention to review the projects at the Development session to be held on 19 March. He further advised that the Integration Care Fund had now been included as part of the NHS funding allocation uplift, with no further funding being made available nationally. Mr David Robertson advised that £66m had been added to Local Authority funding settlements for Health & Social Care Integration.

 

Mr Tris Taylor asked for a copy of the Risk Management Strategy.

 

Mr Tris Taylor sought clarification on ring fenced resources and any consideration attached to the budget. Mr Robertson confirmed that the Integrated Care Fund was made up of £6.3m in total allocated over 3 years to be used as a lever for change. Mr McCulloch-Graham clarifiedthat it was to support integration and each partnership in conjunction with the third sector, health and local authority were to use the funding to develop integrated projects.

 

Further discussion focused on: the intricacies of budget setting in regard to targets and forecasting, financial estimates, assumptions and managing risks; stratified information available to be able to provide oversight; measuring the activity set against the provision and cost of resource to enable effective commissioning; lobbying government for additional funding to deal with pressures; urgency to review integration care fund projects; no designation around the integration care fund monies within the NHS allocation; funding sought to offset costs against increased bed numbers in care home, increased carer hours; potential to utilise some of the £407k balance of the Older People’s Change Fund; potential for future funding for a mental health older adult outreach service into care homes; financial budget for 2018/19; and confirmation that the transformation programme would be responsible for all of the required savings to be achieved in 2018/19.

 

Mrs Jenny Smith raised a concern that the monies allocated by the Scottish Government for the implementation of the Carers Act, within the Social Care Fund might be allocated elsewhere. Mr Robertson advised that the bulk of the £7.4m had been allocated to date on various issues associated with the Carers Act, such as the living wage. Mrs Smith enquired if the £40k had been protected. Mr Robertson advised that he would investigate and provide clarification.

 

Mr Robertson advised that in the current financial year there had been £7.54m given to Scottish Borders Council on a recurrent basis and in the current year Scottish Borders Council had not required to utilise all of that funding and had  ...  view the full minutes text for item 7.

8.

Transformational Programme Update pdf icon PDF 94 KB

Additional documents:

Minutes:

Mr Robert McCulloch-Graham gave an overview of the content of the report and advised that it would be updated in terms of savings.

 

Cllr Helen Laing enquired about the 2018/19 provision of funding for dementia services. Mr McCulloch-Graham advised of the projected 60% increase in the over 65s over the next 10 years and that SB Cares were required to deliver against that as well as a number of beds and hours. On the acute side the sum of £4.8m capital had been agreed and would be put towards developing dementia resources and buildings and conversations with private providers and he was hopeful that Scottish Borders Council might be able to increase capacity, however he was not sure at this stage of the impact on revenue.

 

Cllr Laing enquired if existing buildings would be converted. Mr Philip Barr commented that SB Cares were currently exploring a strategic plan on what the future need would be for adult social care, care homes and dementia care. Discussions were taking place to look at what was required and how it would be delivered, with commissioning helping to inform the strategic decisions and broad strategic proposals.

 

Further discussion focused on: further information was required in regard to items 4 and 6; provision of an equality impact assessment; request for an updated project gantt chart; failure of delivery against the plan with no recovery plans for projects; deadlines to measure against; and format to be revised and include milestones, financial savings and any mitigating actions.

 

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

 

 

9.

Festive Period Report pdf icon PDF 22 KB

Additional documents:

Minutes:

Mr Rob McCulloch-Graham gave an overview of the content of the report and highlighted, more people attending the Borders Emergency Care Services; increase in attendances at the Emergency Department mainly due to respiratory conditions; reduction in admissions however those admitted were more acutely ill; lower discharges across the festive period (24-26 December); access to Craw Wood and Waverley throughout the period; mainstream care homes unavailable; and cancellation of elective procedures increased.

 

Mr David Davidson noted that during the festive period nobody had waited longer than 20 minutes to be triaged.

 

Mr Davidson further suggested the Chair might consider sending a letter to the partnerships involved to thank them for their support over the festive period.

 

Mr Tris Taylor noted that despite the increase in the acuity of patients admissions continued to be avoided and he suggested the same performance might be achieved throughout the year to reduce admissions.

 

Ms Debbie Rutherford noted that carers were not mentioned in the report and asked that the carers national helpline be mentioned in the final winter period report.

 

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

 

10.

Strategic Planning Group Report pdf icon PDF 71 KB

Minutes:

Mr Robert McCulloch-Graham gave an overview of the content of the report.

 

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

 

 

11.

ANY OTHER BUSINESS

Minutes:

11.1     Borders Alarms: The Chair advised Mr Colin McGrath that any issues with Border Alarms would be a matter for Scottish Borders Council and not the Integration Joint Board.

 

11.2     Melrose Health Centre: The Chair advised Mr Colin McGrath that any issues in regard to the Melrose Health Centre would be a matter for NHS Borders and not the Integration Joint Board.

 

11.3     Development Session: Mr Robert McCulloch-Graham reminded the Board of the proposed content for the forthcoming development session to be held on 19 March 2018.

 

11.4     Extra Ordinary Meeting: The Chair advised that an Extra Ordinary meeting would be held to discuss the Integration Care Fund projects and 2018/19 Budget.

 

11.5     Performance: The Chair advised that he would write to the partnerships in regard to performance over the winter period.

12.

DATE AND TIME OF NEXT MEETING

Monday 23 April 2018 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 23 April 2018 at 2.00pm in Committee Room 2, Scottish Borders Council.

 

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