Agenda and minutes

Apologies had been received from Mrs Pat Alexander, Cllr Jim Torrance, Mr Andrew Leitch, Dr Sheena MacDonald, Cllr David Parker and Mrs Jenny Miller.

The Chair confirmed the meeting was quorate.

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

Monday 27 April 2015

The minutes of the previous meeting of the Health & Social Care Integration Shadow Board held on 9 March 2015 were approved. 

The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 27 April 2015 were approved. 

Action Tracker

4.1          Minute 2: Standing Orders:  Susan Manion clarified that following a discussion she had had with the Chairman of NHS Borders both the Medical Director and Director of Nursing & Midwifery were invited to be non voting members of the Integration Joint Board.  In line with legislation a GP representative was also being sought as a non voting member of the Integration Joint Board.

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

Mr James Lamb gave an overview of the content of the report.  He highlighted the feedback received on the Draft Scheme of Integration from the Scottish Government and the engagement events that had been held and those that were scheduled to take place over the summer period to enable engagement on the Draft Strategic Plan.   

Discussion focused on the importance of the engagement process and the reinforcement that the draft strategic plan was a co-production; staff and public attendance at engagement events; costs of publicising engagement events verses attendance levels; interaction at engagement events; using wider tools for engagement such as community councils and councillors; targeted approach to home carers; learning from Heriot Watt event; and format of attendance at the forthcoming Kelso Show. 

Mr John Raine reminded the Integration Joint Board that the draft scheme of integration was owned by both partners and would require further negotiation and resolution prior to being resubmitted to Scottish Ministers for further review.  Mrs Manion advised that there were 36 key points raised of which most focused on wording; clinical and care governance approach; clarification on developing a performance framework and describing the delivery of services and how that was reported.  Mrs Manion further advised that both Mrs Tracey Logan and Mrs Jane Davidson would be meeting to discuss the points that had been raised.  The next iteration was due at the end of July. 

MrRaine commented that both partners should not allow themselves to be pushed into making changes that were not in the legislation and suggested seeking legal advice was important in that regard. 

Mrs Jane Davidson commented that formal feedback had not yet been received by herself and Mrs Logan.  Mrs Tracey Logan commented that there was nothing that could not be overcome and agreed with Mr Raine that it was important to receive legal advice and not to be pushed into a certain direction.  She was resolute that the partners interpretation must be clear.

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

Dr Eric Baijal presented the draft strategic plan and spoke of co-production, and meaningful engagement with stakeholders.

A debate ensued regarding the readability of the document, its format and content.  Several key suggestions and points were raised including:  a plain English version of the strategic plan; version control; style, language and grammar; description of the Integration Joint Board; budget description; acronyms; reflect staff skills, knowledge and experience; inclusion of measurements and outputs; formation of an executive summary; inclusion of MEPs in consultation process; inclusion of projects being taken forward to make the document more tangible to the public; and inclusion of commissioning change, inequalities, what is the aim.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the draft Strategic Plan.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD sought a revised version of the plan given the comments received during discussion.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed to seek virtual adoption and approval of the revised Draft Strategic Plan in order to release it for a 3 month public consultation.

Tracey Logan left the meeting.

Elaine Torrance left the meeting.

Mrs Evelyn Rodger advised the Integration Joint Board on the expectations of revalidation for registered nurses and midwives.  She highlighted several elements including; revalidation through appraisal systems; third party confirmer; system pilot by NHS Tayside: and ageing nursing workforce.

Mr David Davidson sought assurance from NHS Borders and Scottish Borders Council (SBC) that the standard of nursing care provided by NHS Borders and the various care providers commissioned by SBC would be delivered at the appropriate professional standard required. 

Mrs Rodger confirmed that NHS Borders nursing staff worked to their professional standards and advised that non NHS providers would be invited to be involved in the learning from the Tayside pilot. 

Cllr John Mitchell enquired if the “good character” element was the individual with the employer confirming it.  Mrs Rodger advised that it was the individual with both the employer and the third party validator confirming good character and she gave an example of a situation where good character could not be confirmed.

Mrs Susan Manion advised that Mrs Elaine Torrance would bring a paper to a future meeting on the role of the Chief Social Work Officer and the expected professional standards of Care Homes. 

Mrs Rodger advised that Nursing & Midwifery Revalidation was included as part of NHS Borders Strategic Risk Register and suggested it be included in the Integration Joint Board risk register. 

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

Mrs Susan Manion introduced the revised business cycle.  Cllr Catriona Bhatia sought views on any potential Integration Joint Board and Development session agenda items. 

Discussion focused on the Programme Board and it was noted that the Highlight Report was essentially the Programme Board report. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the revised business cycle for 2015/16.

Mrs Carol Gillie reported the position at 31 March 2015 which was still subject to review by external audit.  She advised that the budgets for 2014/15 were as per the original scope and there was a £620k overspend on a budget of £132m.  Mrs Gillie highlighted that despite significant investment the pressure on older people’s services was likely to continue in the future and with regard to prescribing the main issue remained the volatility of drug prices.

MrsGillie confirmed that the partner organisations continued to project a break even position at the year end as each partner would manage their respective overspend areas. 

Mrs Karen Hamilton queried the “holiday pay” element of the overspend in the Older Peoples Service.  Mr David Robertson commented that it had been a consequence of an additional charge in year.  Mrs Gillie confirmed that holiday pay was built in normally.

Mr David Davidson enquired if given the volatility in drug prices a contingency should be held for that specific purpose and built into budget planning.  Mrs Gillie clarified that the Medicines Resource Group undertook forward planning and as part of their financial uplift they were required to take into account unseen events. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the budget monitoring report for 2014/15.

Mr David Robertson presented the first report of the new financial year and emphasised that the information within the report was to be treated as a point in time.  He confirmed that budgeting remained on an aligned basis and any overspend would be met by the relative constituent body.  At present monitoring against a budget of £136m showed a small underspend of £28k, however he caveated that pressures were emerging in the Learning Disabilities and Mental Health Services and an action plan had been prepared to mitigate any overspends. 

The Board were advised that volatility in prescribing would continue and there was no evidence of an overspend in that budget area at the present time. 

Mr David Davidson enquired if there was an estimate of what the dental payment would reduce by.  Mrs Carol Gillie confirmed that the dental payment consisted of what was actually spent the previous year. 

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the projected position of break even at 30 April 2015.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted that Budget Holders/Managers would continue to work to deliver planned savings and deliver a balanced budget. Where that was not possible Managers would work to bring forward actions to mitigate any projected overspends. 

11.1     Integrated Care Fund:  Mrs Susan Manion advised that some of the smaller project work (transport, mental health) had been progressed.

Mr Alasdair Pattinson spoke of the concept of a house of care model, explaining that a community healthcare team model was proposed for the Cheviot area along with the appointment of a care coordinator.  The intention was to lead to better engagement of services around vulnerable patients and ultimately better outcomes.  The Torbay model was being used as a template to build on the infrastructure in central Borders to bring together services in a meaningful way for patients.   

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

11.2     Branding:  Mrs Tracey Graham introduced Ms Carin Petterson, Joint Communications Officer for Integration.  Ms Petterson presented a suggested logo for branding purposes.  During discussion it was suggested that the email banner be removed. 

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

Monday 10 August 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 10 August 2015 at 2.00pm in the Council Chamber, Scottish Borders Council.