Agenda and minutes

Apologies had been received from Dr Jonathan Kirk, Dr Simon Watkin, Cllr Sandy Aitchison, Cllr Jim Torrance, Mrs Jane Davidson, Dr Sheena MacDonald, Mrs Evelyn Rodger, Mrs Fiona Morrison and Mr Andrew Leitch.

The Chair confirmed the meeting was quorate.

The Chair thanked Cllr Sandy Aitchison, Dr Simon Watkin, Dr Jonathan Kirk and Dr Doreen Steele for their valued expertise and support during the past year and confirmed that they would step down from the Board at the end of March. 

The Chair advised that Borders NHS Board had confirmed that their membership of the Board post 1 April 2015 would be John Raine, Chairman, NHS Borders, Pat Alexander, Non Executive, David Davidson, Non Executive, Karen Hamilton, Non Executive, and Dr Stephen Mather, Non Executive.

The Chair advised that a discussion had taken place between NHS Borders and Scottish Borders Council and it had been agreed that in moving forward the Board would be known as the “Health & Social Care Integration Joint Board” post 31 March 2015.

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

The HEALTH & SOCIAL CARE INTEGRATION SHADOW BOARD noted there were none.

Monday 9 February 2015

The minutes of the previous meeting of the H&SC Integration Shadow Board held on 9 February 2015 were amended at page 3, penultimate paragraph, to read “Cllr Bhatia suggested Councillors might like to attend a future Borders NHS Board meeting and Non Executive Directors might like to attend a Scottish Borders Council full Council meeting” and with that amendment the minutes were approved.

Action Tracker

4.1       Minute 9: Newsletter:  Mrs Susan Manion advised that the newsletter was due to be released in March.  The Board agreed to remove the item from the Action Tracker.

4.2       Minute 5: Joint Staff Forum:  The Board noted that invitation letters to join the Strategic Planning Group were being produced. 

4.3       Minute 6: Events:  The Board agreed not to pursue additional events and that the item be removed from the Action Tracker.

4.4       Contingency Planning:  Mr David Davidson enquired about contingency planning.  Mrs Carol Gillie confirmed that arrangements would be set out in the Scheme of Integration.

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

Dr Eric Baijal introduced the first draft of the strategic commissioning plan.  Mr Bob Howarth gave an overview of the detail within the plan.  Mr James Lamb highlighted the timescales for the development and consultation periods. 

Mrs Susan Manion reminded the Board that the document remained a “work in progress”.

Cllr Catriona Bhatia advised that the Community Councils would not be meeting in July and suggested a first draft be shared with them at the beginning of June.

Dr Stephen Mather suggested that the document could detail the piloting of specific outcomes to be achieved such as “taking care of the elderly” instead of “we want improved outcomes”.  He suggested stating what achievements the Board wanted to make, defining those achievements and allowing the measuring of those achievements and outcomes at the year end.  Dr Baijal advised that the Integrated Care Fund projects would go some way to addressing that suggestion and he advised that more reflection on that suggestion would be provided in the draft document.

Mr David Davidson commented that he welcomed the idea of an abbreviated more simplistic document.  He suggested that in working up the next shorter version of the public document that elements on public transport and housing also be included. 

Dr Doreen Steele welcomed the different documents for different audiences.  She suggested that the draft plan in its current form was for professionals and did not focus yet on key performance indictors to measure outcomes.  She suggested it be further streamlined in terms of language and approach to make it a more engaging read for people. 

Cllr John Mitchell enquired if it could be called the Strategic Commissioning Plan 2016/2026 or for the 3 year period 2016/2019 as it would not be fully functioning in the 2015 period. 

Dr Baijal advised that there had been a positive discussion with community planning colleagues and a benefits realization matrix was being worked up, the document would be streamlined and in moving forward the plan would be regularly reviewed as part of the commissioning cycle.

Cllr Bhatia sought assurance that the GP community would be involved and engaged with as they would be key to the delivery of the commissioning plan.  Mrs Manion advised that she would be meeting with the GP Sub Committee in the first week of April.  Dr Baijal also advised that the community engagement toolkit provided a logical framework in which to proceed to engage with GPs. 

Mrs Tracey Logan and Mrs Jeanette McDiarmid were keen to meet with GPs in each locality area along with Mrs Manion in order to understand and explore locality issues with them. 

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

The HEALTH & SOCIAL CARE INTEGRATION SHADOW BOARD agreed to receive the final version of the Strategic Commissioning Plan in advance of publication to the public. 

Cllr Catriona Bhatia introduced the Inpatient Services Review paper advising that Borders NHS Board had approved the commencement of a review of NHS Borders Inpatient services.  She suggested that as the conversations with communities would take place during the same consultation period for the Strategic Commissioning Plan there was an opportunity to coordinate engagement sessions to widen discussions to cover both items.  Dr Eric Baijal commented that such an approach may be helpful given that there was a lot of synergy between both documents.

The HEALTH & SOCIAL CARE INTEGRATION SHADOW BOARD noted the commencement of the review of NHS Borders Inpatient services.

Mr James Lamb gave an overview of the content of the programme highlight report.  He spoke of slippage in the high level milestone plan, commented that the draft Scheme of Integration consultation concluded on 13 March 2015, and public engagement sessions had taken place in the five localities.  With regard to lessons learned Mr James emphasized that these were in relation to having a greater lead in time in engagement event planning and advertising.   

Mr Lamb highlighted to the Board the process being followed in terms of recruiting members to the Strategic Planning Group and the induction packs to be produced for those members to bring them up to speed and link them into networks for geographic and interest communities. 

Cllr John Mitchell enquired about the provision of video conferencing facilities to enable those in the community to communicate with the centre.  Mr Lamb advised that the Office Communication Server (OCS) system was being used, however connectivity was dependent on broadband provision in various parts of the Borders.  Cllr Bhatia advised that there was a good provision of video conferencing facilities at the Borders General Hospital. 

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

Mrs Susan Manion updated the Board on the current status of the Draft Scheme of Integration and advised that she, Iris Bishop and James Lamb had met with the Chairs of the workstreams to finalise the narrative of the sections pertinent to their areas of expertise.  Discussions had also taken place with the relevant Policy Unit Officer at the Scottish Government in terms of clarifying the guidance issued by Scottish Government in December 2014.  Authority to approve the Scheme of Integration for submission to the Scottish Government by 31 March 2015 had been delegated from the Borders NHS Board to its Chairman and Chief Executive and likewise from Scottish Borders Council to its Leader and Chief Executive.

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

Mrs Susan Manion gave an overview of the content of the paper and highlighted the groups that had reported at a greater or lesser extent in to the work of the Scottish Borders Community Health & Care Partnership (CH&CP).  She advised that the majority of delivery within the CH&CP would sit within the remit of the Health & Social Care Integration Joint Board, however there were some elements outwith that remit such as children’s services.

Mrs Jeanette McDiarmid advised of the work that had been undertaken through the Children and Young People’s Leadership Group (C&YPLG) and advised that in future it would sit within the Community Planning Partnership (CPP).

Mr David Davidson asked that a diagram be produced of the current position and expected position in a year’s time and the governance routes.  As he and other colleagues were unsighted on the CPP he was keen to understand the linkages, accountabilities and governance route.   

Further discussion highlighted the transition of young people through children’s services into adult services within the same health and social care directorate; commitment of Mrs Tracey Logan and Mrs McDiarmid to work toward the C&YPLG being accountable through the CPP; impact of the Community Empowerment Bill on the CPP.

Mrs Carol Gillie highlighted that the CH&CP had been a formal Sub Committee of the Borders NHS Board, however the CPP had no direct links to the Board therefore there was a need to ensure there were appropriate governance arrangements put in place for children’s services from the health perspective.  She further commented that in other Health & Social Care Integration Board areas where the issue had been raised the majority of partnerships had included children’s services within their scope in order to ensure appropriate governance arrangements were in place for both organisations. 

The HEALTH & SOCIAL CARE INTEGRATION SHADOW BOARD supported the proposed way forward.

The HEALTH & SOCIAL CARE INTEGRATION SHADOW BOARD agreed to receive a diagram on the governance routes for children’s services showing the current position and the future position.

There were no items of business raised under this heading.

Mrs Carol Gillie advised that the report was a by exception report to the end of January 2015.  The budgets reported were as per the original agreed scope, were on an aligned basis and financial pressures remained the responsibility of the individual organizations.  As of April 2016 the responsibility for financial pressures in the Health & Social Care Integration Joint Board would be the responsibility of the Health & Social Care Integration Joint Board.

Mrs Gillie advised that the integrated shadow budget was predicting an outturn position of a £378k overspend.  The overspend was linked to prescribing and in line with previous reports received by the Board.  The key pressure area was GP prescribing linked to high prices of certain drugs and global supply. 

The HEALTH & SOCIAL CARE INTEGRATION SHADOW BOARD approved the reported projected position of £378k overspent at 31^st January 2015.

The HEALTH & SOCIAL CARE INTEGRATION SHADOW BOARD  noted that Budget Holders/Managers would continue to work to deliver planned savings measures and bring forward actions to mitigate any projected overspends and that NHS Borders would manage the projected overspend on GP prescribing as part of its year end planning.

Mrs Susan Manion detailed the content of the paper.  She advised that further amendments had been proposed after the paper had been issued.  The amendments were highlighted to the Board.   She emphasised that it was important to note that an Integration Care Fund Plan had been submitted to Scottish Government and that four themes had been identified along with the work required to take those four themes forward.  She further commented that it was important to ensure that the governance arrangements around the Integrated Care Fund (ICF) were appropriate and that the resources were used in the way the fund had intended.  Mrs Manion confirmed that the Scottish Borders had been allocated £2.13m. 

Mr David Davidson enquired about audit arrangements for the fund.  Mrs Carol Gillie advised that the allocation was passed through the NHS route and would therefore certainly be subject to NHS Borders audit procedures, however when the Health & Social Care Integration Joint Board became fully functioning the provisions for internal and external audit arrangements for that Board would be required.

Mrs Pat Alexander enquired if plans for the funds had been signed off given that its status was for one year only.  Mrs Manion confirmed that a plan had been signed off and the funds would be utilised to facilitate different ways of working. 

Mrs Alexander enquired when the plans that had been identified for funding would receive the funding.  Mrs Manion advised that there was a process in place to release the funds in April 2015.

Mrs Elaine Torrance welcomed the joining together of the strategic planning process and the ICF.  She noted that project assessment criteria required further refinement and was keen to hear of feedback from service users and their carers. 

Mr David Robertson echoed that the project assessment criteria required further work especially in terms of sustainability and exit planning.  He was clear that there should be no on-going financial commitments beyond the life of the ICF. 

Dr Eric Baijal reassured the Board that there were clear exit plans in place for each work package identified. 

Cllr Catriona Bhatia shared Mrs Alexander’s concerns that the fund was for a period of one year and sought assurance that it would focus on outcomes and services and not on headcount and process.

The HEALTH & SOCIAL CARE INTEGRATION SHADOW BOARD requested that the paper be updated in terms of the wording of the narrative based on the proposed changes. 

The HEALTH & SOCIAL CARE INTEGRATION SHADOW BOARD agreed that the revised paper be circulated for virtual sign off.

The HEALTH & SOCIAL CARE INTEGRATION SHADOW BOARD agreed to receive a note on 1 April 2015 of when the Torbay model in each locality would be going live.

The HEALTH & SOCIAL CARE INTEGRATION SHADOW BOARD agreed to receive a six monthly report on the ICF.

There was none.

Monday 27 April 2015 at 2.00 pm in the NHS Board Room, Newstead

The Chair confirmed that the next meeting of the Health & Social Care Integration Joint Board would be held on Monday 27 April at 2.00pm in the Council Chamber, Scottish Borders Council.