Agenda item

Mrs Carol Gillie gave an overview of the content of the report and highlighted that each savings scheme had an identified deliverability status attached to it. In summary there were £1.1m of schemes identified. Within the schemes was £5.2m of unidentified savings which the IJB had asked the NHS to report back on and given the NHS Board did not meet until the end of June she was unable to provide an update to the meeting.

Mr Tris Taylor enquired about the status of the IJB in regard to financial direction and accountability and enquired if the IJB could make directions about limiting the spending envelope. He further enquired if the IJB was accountable for overspending on the budget given the partner organisations were required to address any overspends.

Mr David Robertson confirmed that the partner organisations would be required to address any overspends. He commented that the IJB had a responsibility to achieve a financial outturn of balance or surplus.

Further discussion focused on: delegated budget; commissioning services; setting direction of travel; issuing directions; end of first quarter with no agreed budget in place; shifting the balance of care to the community and tackling demand; 53% of NHS budget including set aside; and the Scottish Government discussing the totality of the NHS budget and being cognisant of the IJB.

Cllr Shona Haslam enquired what level of detail both financial and non financial would be made available to the IJB in order for it to be assured that any decisions it made in regard to decommissioning services were made in the round and not solely on the basis of finance.

Mr McCulloch-Graham advised that savings proposals would have already been through the robust processes of each partner organisation.

Mrs Gillie enquired of the level of detail the IJB would wish to receive in order to be assured that the decisions it made were in line its strategic plan. Mr Robertson reminded the IJB that it commissioned the partner organisations to deliver a range of services on its behalf and the partner organisations in turn might put in place arrangements to commission services from care providers, the third sector, and voluntary sector.

Mrs Jane Davidson suggested that at present the IJB was unclear on the granularity of commissioning and as it matured it would be able to commission for change.

Cllr Haslam enquired how confident the officers were that the proposals brought to the IJB in the budget would produce a balanced budget, and if not what the consequences would be.

Mrs Gillie advised the IJB that NHS Borders was in discussion with the Scottish Government in regard to the financial position and financial sustainability moving forward.

Mr Taylor enquired why in the meantime the IJB 2018/19 budget and spending could not be determined on assumptions. Mr Robertson reminded the IJB that it had been concerned previously about potentially planning on assumptions and it had been determined that a paper would come to the IJB once the NHS position had been clarified.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the report on the deliverability of 2018/19 savings and efficiencies that are required in order to deliver a balanced budget for the year to 2019.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD asked the Chief Officer to bring forward a plan to the next meeting of the IJB for delivery of savings to address the resource gap in year and recurrently.