Agenda and minutes

Apologies had been received from Mr John Raine, Cllr John Greenwell, Dr Cliff Sharp, Mr Murray Leys and Mr John McLaren.

The Chair confirmed the meeting would not be quorate until Mr Tris Taylor or Mrs Karen Hamilton arrived.

The Chair welcomed Mr Malcolm Dickson (Non Executive, NHS Borders) as a voting member of the Integration Joint Board (IJB). Mr Dickson had been approved by Borders NHS Board on 5 April as a voting member of the IJB to replace Mr David Davidson who had now concluded his term of office as a Non Executive of NHS Borders.

The Chair welcomed Mr Stuart Easingwood, Interim Chief Officer Public Protection to the meeting who was deputising for Mr Murray Leys.

The Chair welcomed Ms Yvonne Chapple to the meeting who was deputising for Mr John McLaren.

The Chair welcomed Ms Vicky MacPherson and Ms Karen Lawrie from the NHS Borders Partnership Office who were shadowing Mrs Yvonne Chapple.

The Chair welcomed members of the public to the meeting.

Mr Robert McCulloch-Graham gave an overview of the content of the report and highlighted increased activity in the secondary care sector, delayed discharges, financial pressures, the protection of individuals and regional activities

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Mr Tris Taylor arrived.

Mr Tris Taylor enquired about the Chief Financial Officer position. Mr McCulloch-Graham recorded his thanks to those who had covered the Chief Financial Officer post on an interim basis to date. He advised that there had not been enough interest received in the post and he was now intending to re-advertise the position. He confirmed that he was also in contact with the Scottish Government in regard to interim arrangements. He assured the Board that measures were in place to ensure financial governance through the support of Mr David Robertson, Mrs Carol Gillie, Mr Leslie Gill and Mrs Susan Swan. He assured the Board the appointment remained a priority.

Mr David Robertson suggested the Board may wish to consider and agree who would sign off the partnership annual accounts for 2017/18 given the current position in regard to a vacancy for the Chief Financial Officer position.

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

The Chair confirmed the meeting was quorate.

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

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the Register of Interests.

Mrs Karen Hamilton arrived.

19 March 2018

The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 19 March 2018 were amended at page 3, minute 6.1, line 3, to read “..funding. However it was agreed that it be included ...” and with that amendment the minutes were approved.

Action Tracker

5.1       Action 22: Joint Older People’s Services Report: Mr Robert McCulloch-Graham advised that he still awaited formal feedback from the Care Inspectorate on the revised Action Plan that had been submitted. He assured the Board that regular contact was maintained with the link inspector. The Chair voiced his frustrations at the lack of engagement from the Care Inspectorate and Mrs Tracey Logan suggested she could raise the matter with Scottish Government colleagues.

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

Mr Robert McCulloch-Graham introduced the Financial Plan presentation.

Mr David Robertson provided an informative presentation that was intended to reflect the paper. During the presentation Mr Robertson covered the full range of financial elements, including: strategic context; flow of funds; achievements the partnership had made; operational context; budget movement; Integrated Care Fund; Social Care Fund; efficiency savings and pressures for 2018/19.

Cllr David Parker sought confirmation that conditions around the implementation of the living wage and Carers Act were calls that would be directed to be fulfilled through social care funding.

Mr Tris Taylor enquired about the split of funding when resourcing joint services, such as a 1.5% increase in funding for the Mental Health Service given the 2018/19 budget was smaller than the 2017/18 budget. Mr Robertson advised that there was an expectation that NHS resources would stay the same. Mrs Carol Gillie confirmed that in moving forward there was a commitment in the NHS allocation letter baseline for 2017/18 compared to 2018/19. Some efficiencies had been delivered in the Mental Health Service which had enabled the 1.5% uplift from the NHS, which Mrs Gillie advised was in effect an allocation rather than an actual.

Mr Colin McGrath enquired of the overall proportion of the NHS budget in the partnership. Mrs Gillie advised that 52% of the NHS budget was transferred to the partnership. Mr Robertson also advised that 100% of the social services budget for all adult services was allocated to the partnership.

Mr Taylor enquired about the ring fenced funding received from the Scottish Government. Mr Robertson advised that ring fenced funding had been received based on future projections which had been estimated in good faith, however the funding did not fully cover the costings and there were therefore pressures to be addressed.

Ms Lynn Gallacher commented that she was aware that the Carers Action Plan implementation monies had been allocated around the various areas and she enquired where the Carers Information Strategy funding currently sat given it was not new money. Mr Robertson advised that there was a proposal to be put before the Strategic Board and a recommendation would be submitted to the Integration Joint Board meeting in June for decision.

Cllr David Parker commented that he understood some funding for the Carers Act payable to the Borders Carers Centre and was already mainstreamed, and he was aware that there were some things requiring payment as they involved salaries for people. Mr Robertson suggested if the Board were not minded to set the budget that day then it would be appropriate for the Board to take the decision to continue to fund certain areas at the discretion of the Chief Officer in conjunction with the Chair and Vice Chair of the Integration Joint Board.

In regard to efficiency savings, Mr McGrath enquired if services were given direction on where to make savings. Mrs Tracey Logan commented that services were made aware of the challenges and pressures within the Council and were asked to formulate proposals  ...  view the full minutes text for item 6.

Mr Robert McCulloch-Graham gave an overview of the content of the report and reminded the Board of the decisions agreed at the last meeting. He then drew the attention of the Board to table 4 page 6 and the recommendation suggested for each project.

Mr Tris Taylor declared a potential conflict of interest in the autism item due to a close relationship with someone who may have autism.

7.1       Delivery of the Autism Strategy: Mr Tris Taylor sought assurance that the action plan would not be compromised by disinvestment in the project. Mrs Tracey Logan assured the Board that mainstreaming of the project and outcomes to be achieved would be appropriate, it was more of a matter of thinking differently about how that was achieved.

Mrs Jenny Smith was mindful of autism in terms of public perception, press, education and working with partners. She accepted that the project was not delivering and wished to be assured on how the agenda around autism would be supported.

Cllr Shona Haslam accepted the inefficient use of resources, however she could not agree to disinvest in the project based on an outcome of too few individuals benefitting from the project, given there was no original objective in regard to numbers of people to benefit from the project.

Mrs Jane Davidson recollected that the Autism Strategy was about the reshaping of services, how the strategy could be mainstreamed and she commented that some of the strategy itself had been aspirational.

The Chair advised of the proposed recommendation within the paper.

Cllr Haslam proposed: funding the project for a further 6 months with a view to mainstreaming into other services; ensuring the autism strategy and action plan were delivered in the mainstream services; and identification of succession planning.

Cllr David Parker seconded the proposal.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the proposal to fund the project for a further 6 months with a view to mainstreaming into other services; ensure the autism strategy and action plan were delivered in the mainstream services; and for succession planning to be identified.

7.2       Delivery of the Alcohol Related Brain Damage (ARBD) Pathway: Both Cllr Shona Haslam and Cllr David Parker raised concerns in regard to the limited evidence and progress with the project. Cllr Tom Weatherston commented that it was a difficult group of people to assist, however he recognised the limited evidence available.

The Chair advised of the proposed recommendation within the paper.

Cllr David Parker proposed to cease the project as soon as practicable.

Cllr Shona Haslam seconded the proposal.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the proposal to cease with the project as soon as practicable.

7.3       Stress & Distress Training: Mr Tris Taylor enquired if the project was integrated with the general scheme of activities around executing the statutory duty required of Health Boards to look after the wellbeing of their staff. Mr Robert McCulloch-Graham advised that the project was focused on pump priming an effective training programme to enable people to  ...  view the full minutes text for item 7.

The Chair gave an overview of the content of the paper and the rationale for amending the meeting cycle.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the increase from 6 formal meetings to 8 per year and a reduction from 5 Development sessions to 3 per year.

Mrs Claire Pearce, outlined to the Board the effects on hospital capacity and staffing levels of a difficult winter period in terms of weather, acuity of patients and staff sickness. She emphasised that the effects manifested on people and gave the example of people having to wait in the Emergency Department in excess of 8 hours. Mrs Pearce enquired if the Board would find it helpful if she brought a quality and governance report on the effects of winter.

Dr Angus McVean suggested the report also involve primary care and welcomed the opportunity to work on a joint report with Mrs Pearce.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the learning and improvement opportunities for next year which would be taken forward by the Winter Planning Board.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD welcomed the opportunity to receive a report at a future meeting on Quality and Governance from Mrs Claire Pearce, Director of Nursing, Midwifery & Acute Services and Dr Angus McVean, GP Clinical Lead.

Cllr Helen Laing left the meeting.

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

Mrs Jenny Smith commented that the Strategic Planning Group (SPG) had been focused on the review of the Strategic Plan and she suggested it should also have more of an eye on performance and be able to provide the Board with an overview of performance. Mr McCulloch-Graham commented that he was also keen for the SPG to monitor performance against the Strategic Plan and then advise the Board accordingly.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the key issues and actions arising via the Strategic Planning Group, in particular progress being made in relation to the refresh of the Partnership’s Strategic Plan.

Mr Stuart Easingwood advised that in regards to the Joint Older People’s inspection the interface between the services and the Care Inspectorate was not ideally where he would like it to be. However, there was progress being made in line with the action plan and within those timescales. He assured the Board that there were no matters outwith the timescales planned, and a further meeting with the Care Inspectorate was awaited.

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

Mr Tris Taylor commented that it did not feel like an adequate set of indicators to monitor against. He suggested that the measures evolved out of policy and in terms of performance against what he would perceive the public would wish to see they would fall short.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the additional/amended measures for reporting.

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

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD did not advise of any further measures to be considered for inclusion in future quarterly performance reports.

Mr Malcolm Dickson enquired if the Integration Joint Board participated in Equality and Diversity week.

Mrs Jane Davidson suggested the Board may wish to direct the Chief Officer to participate in it. She commented that the week had been a success and had been led by the Joint Public Health Team across NHS Borders and Scottish Borders Council and welcomed the involvement of the Integration Joint Board.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the Equality Mainstream Report.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the draft Progress Report for publication.

14.1 Social Isolation & Loneliness: Mr Colin McGrath commented that at a recent Locality meeting the Scottish Government document on Social Isolation and Loneliness had been mentioned and he suggested the Board may wish to respond to the document. Mr Robert McCulloch-Graham advised that he would discuss the matter with Mr McGrath outwith the meeting.

Monday 11 June 2018 at 2.00pm in 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 28 May at 9.30am in Committee Room 2, Scottish Borders Council.