Agenda and minutes

Apologies had been received from Mr John Raine, Dr Stephen Mather, Cllr John Mitchell, Cllr Francis Renton, Cllr David Parker, Dr Sheena MacDonald, Mrs Jeanette McDiarmid, Mrs Fiona Morrison, Mrs Jenny Miller and Mrs Tracey Logan.

Mrs Lynn Gallagher deputised for Mrs Fiona Morrison.

The Chair confirmed the meeting was not quorate.  The Board agreed to discuss the items on the agenda and homologate them at the next meeting.

The Chair formally recorded that she had been asked to chair the Health & Social Care Integration Joint Board for 2015/16 and had accepted.

Miss Iris Bishop introduced the draft Standing Orders.  During discussion several amendments were suggested including: re-titled to Interim Standing Orders; date and version control to be included; page 2 item 3.4 the Chair shall specifically; and page 6 item 13.1 seven days.

The Board recommended that there should be two staff representatives at the meetings (one from Scottish Borders Council and one from NHS Borders) and asked that the health professionals membership be reviewed in terms of the guidance as to whether both the Medical Director and/or the Director of Nursing & Midwifery should be non voting members.

The Chair noted that the role of Board members was an item for the Development session being held on 20 May and suggested it be broadened to include a discussion on membership of non voting members.

Cllr Jim Torrance suggested if GPs were non voting members then Community Nurses should also be invited.  The Chair was keen to differentiate between the Board membership and the Strategic Planning Group membership which encompassed representatives from the GP and Community Nursing communities.

The HEALTH & SOCIAL CAREINTEGRATION JOINT BOARD discussed the Interim Standing Orders and suggested amendments for homologation at a future meeting. 

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

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

Monday 9 March 2015

The minutes of the previous meeting of the Health & Social Care Integration Shadow Board held on 9 March 2015 were noted and would be formally approved at the next meeting. 

Action Tracker

5.1         Minute 5 Establishment of Strategic Planning Group:  Mrs Susan Manion confirmed that letters had been issued to the relevant stakeholders inviting representation. 

5.2       Minute 9 Disestablishment of the Scottish Borders Community Health & Care Partnership:  Mrs Susan Manion advised that the matter would be discussed with the Programme Board in the first instance. 

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

Mr James Lamb presented the report.  He highlighted several elements within the report advising that the Scheme of Integration had been submitted by the due date of 31 March 2015; consultation on the Strategic Plan had commenced and a series of public engagement events had been scheduled.

The HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD noted the report.

Mrs Susan Manion introduced the framework that had been developed by the workforce workstream lead by Mrs Claire Hepburn and Mrs June Smyth (previously Mrs Edwina Cameron).  She commented that it was important to think about the organisation from front line staff through to Board members and in doing that the recruitment to an additional resource requirement had been identified from the monies allocated for the transitional period. 

The Chair enquired if the Board members would be copied into the newsletter to staff.  Mrs Manion confirmed that it would be shared with the Board members.

Mr David Robertson suggested that updates be provided for all Board members and suggested amending the text on page 3 to read “Elected members and NHS Board members”.  The Board were in agreement with the text change.

Mrs Jane Davidson enquired about the term “partnership” that was being widely used and sought clarification if that was in relation to the Health & Social Care Integration Joint Board or the wider communities.  

Mr David Davidson sought a shared list of key people from both organisations that Board members may need to contact for advice or information.  Mrs Manion advised that an Induction pack had been put together for members of the Strategic Planning Group and suggested it be refined for Board members and shared with them at the Development session on 20 May.

Cllr Jim Torrance was keen to be assured that monitoring would take place to ensure a delay in one project would not delay other projects.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD endorsed the Organisational Development Plan subject to the change being made at page 3 and recommended it be homologated at the next meeting.

Dr Eric Baijal presented the document that was being used for engagement events across May.  He advised that the Strategic Plan was for a period of 3 years and was built upon the health and social care needs of the population of the Scottish Borders. 

Mr John McLaren enquired about the mention of Health Visiting within the communication plan as it had previously been agreed that Health Visiting was outwith the scope.  Dr Eric Baijal confirmed that Health Visiting was outwith the scope and he would update the communication plan and ensure it reflected the content of the Strategic Plan.

Mrs Evelyn Rodger sought assurance that the document had been checked for readability.  Mr James Lamb confirmed that an easy read version had been commissioned. 

During discussion several points were made including: ensuring the case for change was teased out to reflect better health outcomes for the population; what is the partnership and did the Integration Joint Board have a locus around that partnership; would something be commissioned to provide a better engaged workforce; as a new Integration Joint Board what would it be commissioning and to what standards would it commission.

Mrs Lynn Gallagher requested that where service users were mentioned, colleagues remembered that carers should be included.   

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted that the initial draft Strategic Plan would be used for the first phase of a joint engagement exercise in support of the production of a Borders Strategic Commissioning Plan.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed to have a Development session later in the year dedicated to Commissioning (the commissioning cycle, review of the Manchester model and lessons learned).

Elaine Torrance left the meeting.

Ms Tracey Graham advised that the communications and stakeholder engagement plan was a working document that was constantly refreshed.  The workstream had focused on the strategic plan document and its promotion.  Engagement events had been set up and were being advertised through various mediums.  Ms Graham confirmed that a preferred candidate had been identified  for the Communications Officer post for Integration.

The Chair enquired about a communication to Elected members and staff.  Ms Graham advised that a newsletter had been prepared for the staff and public and would be updated to reflect the Strategic Plan events and would then be released.

Mrs Lynn Gallagher enquired if there was a separate engagement plan.  Ms Graham advised that at one point there was a communications plan and a separate engagement plan, however both had been combined into one plan and the wording required updating to reflect that status. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD recommended the report for approval at the next meeting. 

Mrs Susan Manion reported that the Scheme of Integration had been submitted by 31 March 2015 and it was anticipated that feedback would be received within a period of 6 weeks.

Mr David Davidson enquired if any notifications of further guidance had been received.  Mrs Manion confirmed that further topic based guidance had been received.  Mrs Carol Gillie advised that further guidance had been received in relation to finance which she and Mr Robertson were reviewing.

Dr Eric Baijal suggested that a regular update bulletin be sent to Integration Joint Board members to keep them abreast of issues, as per the current practice in the Health Board.  Mrs Manion agreed that a regular bulletin could be put in place.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed to receive a regular update bulletin.

Mrs Susan Manion thanked Iris Bishop for producing the Annual Report and advised that it detailed the work of the Health & Social Care Integration Shadow Board over the previous year.

Mrs Lynn Gallagher requested that the report be amended to reflect service users “and carers”.

Mr David Davidson commented that he liked the simplistic format of the report.

The Chair noted that the attendance record required amendment in terms of Iris Bishop’s attendance and also sought confirmation of service user representation. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the Annual Report for 2014/15 subject to the amendments suggested.

Mr David Robertson advised that the total resources under the report were £133m in the current year.  The key issues were an overspend of £677k for the partnership with a projected year end position increased due to the inclusion of an overspend in the People Department of Scottish Borders Council which had not previously been reported.  The overspend within NHS Borders related to GP prescribing as previously reported. 

Overall the People Department were projecting a balanced position.  The overspend on the elements of the integrated budget would be managed through contingency slippage and control measures previously reported to the Integration Joint Board. 

Mr David Davidson enquired if at the end of the financial year the Integration Joint Board would have a zero balance.  Mr Robertson confirmed that it would have  zero balance as the overspends would be managed by Scottish Borders Council and NHS Borders.

Mrs Carol Gillie commented that if it was a live situation and the budgets were not being run on an aligned basis the Integration Joint Board would end the financial year with a significant overspend. 

Mr Davidson enquired how the budget would be projected for the coming year given it would start from a zero position.  Mr Robertson advised that part of the exercise was a due diligence process which looked at expenditure over the previous 5 years to establish the budget for year 1.  He advised that such issues could be considered as part of the Development session on 20 May.

Mr Davidson suggested it would be helpful to discuss how costings would be added to proposals that would be put to the Integration Joint Board and how they could be managed over time as he anticipated that there would be aspirations to develop services and that would come with a cost attached.

Dr Eric Baijal clarified that the Integration Joint Board was speaking of transformational change within the same financial envelope but with improved outcomes via the strategic planning process. 

Mrs Jane Davidson enquired as a commissioning body what the implications were from a financial perspective.  She urged the board to be clear moving forward what the differences were and what the responsibilities were as they could be limited by financial spend. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the reported projected position of £677k pressures at 28^th February 2015.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted that additional funding had been earmarked from elsewhere within NHS and SBC non-integrated budgets enabling a balanced breakeven position to be reported

The HEALTH & SOCIAL CARE INTEGRATION JOINT 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 and that Scottish Borders Council would continue to deliver its action plan to further reduce the projected Adult Services pressures during March.

Mrs Carol Gillie introduced the paper advising that it set out the Integrated Budget for 2015/16.  It was based on services agreed in 2014/15 and included other services taking into account the national consultation exercise and services that must be included.  It was therefore a slightly different scope to the previous year and where it had not been possible to disaggregate adult services the full budget had been includes ie GP prescribing for the whole population. 

Mrs Jane Davidson suggested including efficiency savings within the budget element of the Development session.  Mr David Davidson welcomed the suggestion and commented that it should include both how the Board, Scottish Borders Council and NHS Borders will manage their efficiency savings.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the scope and associated financial resources of the integrated base budget for 2015/16 totalling £135.2m prepared on an aligned basis as set out in appendix 1.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted that an Integrated Joint Board development session was planned for 20^th May 2015 to discuss in more detail the budgets as set out in appendix 1.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted that the draft Partnership Strategic Plan would be developed based on the integrated budget and would include information on the set aside budget as set out in the consultation papers.

Mrs Susan Manion reported that the Integrated Care Fund would continue for a further 2 years (2015/16, 2016/17, 2017/18).  She advised that the Programme Board would be meeting to outline the specific actions that would be taken forward as a priority for service development and progress would be shared with the Integration Joint Board.

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

15.1     Resilience:  Mr David Davidson advised that he was the Chair of the NHS Borders Resilience Committee.  He was keen to explore telecommunications coverage in the Scottish Borders and eluded to the Scottish Borders Council paper entitled “Our Borderlines our Future Final Report”.  He suggested that NHS Borders and Scottish Borders Council work together collectively to try and engage the centre to see what could be progressed with connectivity in the region.

            Mr Davidson advised he would pass the link to the paper to the Board Secretary to email out to Board members.

15.2     Managerial Organisational Changes in NHS Borders:  Mrs Jane Davidson advised the Board that the acute management structure at NHS Borders was being reviewed with a focus on putting the patient at the centre.  She advised that a consultation paper had been released in January 2015 which discussed the proposed management revisions and the barriers between primary, acute and social care services.  One of the main aspects of the reorganization was to support the Health & Social Care Integration Joint Board to commission for a reduction in admissions, preventable admissions, take expertise to the patient, invest in medical leadership, reduce management costs, etc. 

15.3     Information Technology:  Cllr Catriona Bhatia advised that there was a consultation underway in regard to the potential to outsource Information Technology services from Scottish Borders Council.  Mrs Jane Davidson confirmed that NHS Borders had written to Unite expressing concern at their narrative relating to NHS staff. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the updates.

Monday 22 June 2015 at 2.00pm in the Council Chamber, Scottish Borders Council

The Chair confirmed that the next meeting of Health & Social Care Integration Joint Board would take place on Monday 22 June 2015 at 2.00pm in the Council Chamber, Scottish Borders Council.