Agenda item

Mrs Susan Manion gave an overview of the content of the report.  She highlighted several key elements including: draft budgets to be delegated and summary of delegated functions; highlighting the set aside budget; financial risks of resources available to it and the mitigation that had taken place; due diligence; base line; understanding of existing and evidenced emerging pressures; and planned efficiencies.  Mrs Manion was keen to stress she was absolutely clear of the intent to complete the planned efficiencies work across the systems to ensure there were plans in place through the NHS in order to be able to provide assurance to the Health & Social Care Integration Joint Board on the sufficiency of resources. 

Mrs Manion further highlighted that Scottish Borders Council had agreed its efficiencies and the NHS given their later national timeframe had been unable to confirm their efficiencies to date.  She suggested further work would be undertaken on the financial statement and the accompanying due diligence report and both would be submitted to the next meeting.

A discussion ensued that focus on several matters including: caveats in place until a settled financial position for the NHS is reached; £5m for development and refinement of Health & Social Care Integration Joint Board services;  further guidance on the £5m to be issued by Scottish Government; double counting of £5.2 sitting in baseline budget for both Scottish Borders Council and NHS Borders; and the Health & Social Care Integration Joint Board would direct Scottish Borders Council through written directions how to use the £5.2m.

Mr David Robertson quoted from the John Swinney letter to all Council Leaders and advised that he would share the letter with Health & Social Care Integration Joint Board members.

Cllr John Mitchell enquired how the financial figure was arrived at for the NHS.  Mr McMenamin confirmed that it was a calculated share of NHS Borders financial budget for 2016/17 as at present and a determination of set aside.  Mrs Carol Gillie expanded on the explanation and advised that legislation and guidance defined which services were set aside.  She advised she would happy to provide Cllr Mitchell with more detail outwith the meeting. 

In regard to efficiency savings Mr John Raine recognised that the Health & Social Care Integration Joint Board needed to be assured on the affordability of the functions delegated to it.  He advised that the NHS dealt with efficiency savings each year by tasking senior staff and others including Board members to find efficiency savings during the course of the financial year.  He advised that NHS Borders was required to make £11m savings in 2016/17 and was not at present in a position to identify in detail how those savings would be achieved.

Mrs Manion highlighted the differences between the two organizations processes in dealing with financial gaps and savings targets.  She clarified that there were ongoing discussions within the NHS about the level of efficiencies and where they could be achieved and where the headline figures were.  She reiterated that the NHS was complex in terms of different budgets sitting within it and efficiency plans across the whole system were being considered and the determination of an efficiency level for the Health & Social Care Integration Joint Board was determined by a proposition of the totality of the NHS Budget.

Mrs Elaine Torrance sought assurance on the potential impact on joint services and delivery of the strategic plan.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the current position in relation to the production and agreement of a fully evidenced and funded joint delegated and notional budget for 2016/17 for the Scottish Borders Health and Social Care Partnership

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed that further work should be undertaken to bring forward efficiency proposals within NHS Borders 2016/17 financial plan (delegated or non-delegated) or alternatively, identify other sources of potential funding in order to fully fund the proposed level of budget to be delegated to the Partnership on the 1^st April 2016.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed that a final financial statement accompanied by a full assurance report be presented to the Board prior to the 1^st April 2016 for approval, requiring the convention of an extra-ordinary meeting in late March 2016