Agenda item

Mrs Susan Manion gave an overview of the content of the update.

Mr John Raine expressed concern in regard to the projects and governance arrangements for the integrated care fund.  He was unaware that the Health & Social Care Integration Joint Board had agreed to the total commitment of the £6.39m over 3 years.  He sought greater clarity on what the £6.39m would purchase, what would be achieved and if it was viewed as a priority for the Health & Social Care Integration Joint Board.  In terms of accountability he sought clear financial governance by the Health & Social Care Integration Joint Board for the approval of projects above a certain financial level, supported by documentation that clearly set out the projects contribution to meet the objectives in relation to the strategic plan, cost, sustainability and exit strategy.

Mrs Manion highlighted the governance arrangements detailed at Appendix 3 to the paper which was an attempt to simplify a cumbersome and bureaucratic system.  She was clear in relation to the approved projects that they had been through a rigorous process in relation to the analysis of the criteria, analysis of where they sat in relation to outcomes and exit strategies.  She confirmed that all additional posts/resources were short term contracts. 

Mr David Davidson recalled that it had been previously agreed that the Health & Social Care Integration Joint Board would receive 6 monthly updates on which projects were progressing well and which were not and why.  He did not recall the Health & Social Care Integration Joint Board delegating up to £500k without any reference to the Health & Social Care Integration Joint Board itself or that the Chair or Vice Chair could sit in judgement on behalf of the Health & Social Care Integration Joint Board. 

Dr Stephen Mather shared Mr Raine and Mr Davidson’s concerns.  He suggested that the integrated care fund had not been used for targeted planning and wished confirmation that proposals had been through a full robust business case to ensure monies were targeted better to give proper outcomes.

The Chair shared similar concerns and noted a key piece of missing information was how the projects would be mainstreamed.  She commented that whilst the Change Fund had had its difficulties the learning from that process should be used to inform the process for the integrated care fund to ensure information was presented in an understandable, meaningful and straightforward way.

Mrs Jane Davidson commented that the Executive Management Team were also of the view that governance arrangements required revision.  She advised that Mr David Robertson had been charged with simplifying the arrangements.  In future she would expect the Executive Management Team to review all identified projects and for the Health & Social Care Integration Joint Board to be asked to approve, consider and endorse both those projects above and below the financial threshold provided they clearly stipulated the targeting of outcomes, mainstreaming and exit strategy.

Further discussion focused on: assurance from officers; the success of project My Home Life (training for managers in care homes); linking outcomes from projects to the strategic plan outcomes; engagement with GPs; interface with specialist contracted GPs; a 1% shift in resource; return on investment; shift in emergency admissions; provision of more care at home; and the role of internal audit.

Mrs Tracey Logan summarised that the integrated care fund had been operated as per an agreement reached some time ago, she assured the Health & Social Care Integration Joint Board that projects were scrutinised and outcomes were clear.  She further commented that the integrated care fund was not as joined up strategically as the Health & Social Care Integration Joint Board would prefer and she appreciated that the Health & Social Care Integration Joint Board had not had the visibility of projects that it required.  Mrs Logan suggested a full report be submitted to the next meeting of the Health & Social Care Integration Joint Board. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the update and agreed to accept a full report at its next meeting on 20 June 2016.