Agenda item

Mr Paul McMenamin gave an overview of the content of the paper, highlighting the input of the Executive Management Team and a number of key high level roles across key stakeholder groups.  Mr McMenamin described the flow of business within the revised governance arrangements and clarified that the Health & Social Care Integration Joint Board (IJB) would be asked to ratify proposals.

Mr John Raine welcomed the move towards a simpler form of governance.  He also welcomed the inclusion of statements in the report that the IJB was ultimately responsible for the effective use of the Integrated Care Fund (ICF) and also the reference to the role of the IJB being to set the strategic intent of the partnership.  He also emphasised that the Board was responsible and accountable for the success or otherwise of the whole enterprise of integration.  There were however some contradictions in the report.  It stated that the Executive Management Team (EMT) would be responsible for refining and approving proposals and that once approved they could be implemented.  However, the report also stated that the Board would be asked to ratify proposals approved by the EMT and might refer proposals back. 

Mr Raine stated the definition of `ratify` was to formally approve which could present difficulties if proposals were already being implemented.  Board approval of proposals would not delay implementation if work was effectively programmed and also because the Board met frequently.

Mr Raine indicated that the process should be simple and clear with schemes supporting the delivering of the ICF programme going to EMT for endorsement and then on to the Board for final approval with an explanation as to what the schemes were intended to achieve, at what cost, over what timescale and how sustainable they would be.  The Board would then ratify or refer back. Worked in this way, the governance would be simple and clear and support the fact that the Board was ultimately accountable.

Mrs Susan Manion advised that the role of the EMT was in terms of delivery.  She explained that the EMT was the place where the Chief Executives as decision makers in commissioning services would agree to the delivery of the services requested by the IJB.  The IJB on strategic matters was itself advised by the Strategic Planning Group.  The role of the Chief Officer was to make the recommendation to the IJB to commission the services.  She commented that the advantage in the setting up of the EMT was that it converged into a single group and was easier to then take a collective decision and collective view on the way forward in line with the IJBs requirements.

Ms Jenny Miller enquired if there would be third sector representative on the proposed Service Redesign Steering Group.  Mr McMenamin advised that the membership and terms of reference for the working groups would be redefined with the intention that the former membership, form the main membership of the Service Redesign Steering Group plus other stakeholders. 

Mr David Davidson suggested the second sentence in paragraph 4.6 was contradictory as per Mr Raine’s earlier comments.  Mr McMenamin advised that he would be content to remove that sentence from the report as it added little value by way of explanation.    

Discussion further focused on: the purpose of the proposed new groups; description of the whole system in terms of the use and totality of resource; streamline process and provide assurance that funds were being spent in appropriate areas; and potential routes for appeal.

Mrs Karen Hamilton questioned whether any proposals not agreed by the EMT would be seen by the IJB.  Mrs Jeanette McDiarmid explained that the EMT would provide the IJB with assurance that the recommendations submitted to it met the outcomes in the strategic plan, enabling the IJB with its decision making.  She further advised that if the IJB did not approve a recommendation it would be referred back to the EMT. 

Towards the end of the discussion Mr Raine said he was happy to support the proposals following the assurances given by the Chair and Mrs McDiarmid that the governance process was intended to run in the way he had earlier outlined.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the revised governance arrangements for the Integration Care Fund subject to the deletion of sentence 2 at paragraph 4.6 on page 4 of the paper.