Agenda and minutes

Apologies had been received from Cllr Catriona Bhatia, Mr John Raine, Cllr David Parker, Mrs Fiona Morrison, Dr Sheena MacDonald, Mr Alasdair Pattinson and Mr John McLaren.

The Chair confirmed the meeting was quorate.

The Chair welcomed various attendees to the meeting including Mr Bob Howarth, Ms Sandra Pratt and Dr Angus McVean.

The Chair welcomed members of the public to the meeting.

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

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

Monday 10 August 2015

The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 10 August 2015 were approved.

Action Tracker

4.1       Minute 7: Interim Standing Orders: Miss Iris Bishop to reissue the revised Standing Orders.

4.2       Minute 15: Chief Financial Officer Update: Mr David Robertson advised of progress reporting that a Job Description had been agreed and advertisement was expected to take place in the next two weeks.

4.3       Action Tracker Minute 9: Children’s Services: Mrs Elaine Torrance confirmed that the new arrangements for Children and Young Peoples services to report to the Community Planning Partnership had been agreed. She undertook to circulate the paper to Health & Social Care Integration Joint Board members for information.

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

Director of Strategy

Dr Eric Baijal introduced the revised draft strategic plan and advised that approval was sought from the Health & Social Care Integration Joint Board to consult on the revised version of the Strategic Plan for Health and Social Care Integration.

Mrs Susan Manion recorded her thanks to all those involved in the formulation of the plan particularly Mr James Lamb and Ms Carin Petterson.

Mrs Evelyn Rodger enquired in regard to how we would be looking to achieve the new standard of discharges over 72 Hours. Mrs Susan Manion commented that it would sit within the context of the performance framework. It was noted that an update on delayed discharges would be given at a future meeting.

Mrs Karen Hamilton noted a grammatical change required on page 19.

Mr David Roberson suggested revising the wording at the bottom of page 15 to “recognising patterns of inequality and deprivation”.

Mrs Jenny Miller suggested the inclusion of further detail on how anticipatory care planning was measured on page 23.

The Chair on behalf of the Health & Social Care Integration Joint Board, thanked all involved in the formulation of the final document.

The HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD approved the draft Strategic Plan “Changing Health and Social Care for you – a further conversation” for public consultation, subject to any further revision required.

Chief Officer

Mr Bob Howarth updated the Health & Social Care Integration Joint Board members on the progress of allocating funds from the Integrated Care Fund. He highlighted that the key areas that had been looked at in regard to the Integrated Care Fund plan had been consolidated within the strategic planning work in order to strengthen assessment processes and ensure robust strategic and financial allocation.

Mrs Sandra Pratt briefed the Health & Social Care Integration Joint Board members on progress with the Eildon proposal. She advised that a stakeholder meeting was being held on 29 October 2015 to bring together people from the locality including community and acute staff to help shape the model in terms of how workable and manageable it might be and to refine the submission to Integrated Care Fund.

Dr Angus McVean suggested the GP community may have significant concerns about the Eildon project, that it had been developed at a strategic level and that it lacked in input from primary care providers. He welcomed the stakeholder session on 29 October 2015 and the input of GPs to that session.

Mrs Susan Manion reiterated that the Eildon project was an outline plan with the intent to demonstrate progress. She welcomed the input of GPs to the engagement process.

Mrs Pratt confirmed that the project was a concept for primary care and acute to explore and agree. An outline had been submitted to the Integrated Care Fund in order to advise them that as the project developed and progressed, resources would be sought. The locality would be the driving force behind the project taking into account the potential impacts on both acute and primary care services through testing the model to see if it was appropriate and workable. She advised that all GP Practices in the locality area had been contacted and all but two had given feedback. The GP Practices were keen to participate and engage on the project.

DrMcVean advised that he was now assured that GP input was taking place, however he would have preferred the GP Local Negotiating Committee (LNC) to have been engaged with at an earlier stage.

The Chair commented that the Health & Social Care Integration Joint Board recognized it was important to ensure GPs and all stakeholders were engaged with on all the initiatives that would be developed, tested and established.

Cllr Jim Torrance was surprised to hear Dr McVean’s comments given that Dr Jonathan Kirk and Dr Sheena MacDonald had spoken of the proposed project at various meetings. He further commented that potentially with the success of such a project community hospital beds might be reduced.

Mr David Davidson commented that good engagement with all stakeholders on any project or service change was a key factor of good governance. If a bid were submitted to the Health & Social Care Integration Joint Board to consider, it would wish to be assured that the bid was worthwhile, achieved outcomes and that the background to it was fully understood.

Cllr John Mitchell enquired if  ...  view the full minutes text for item 6.

Programme Manager

Mr James Lamb provided an outline update on progress on the delivery of the Integration Programme and advised that the project work was now moving to conclusion as the programme moved into the implementation stage. He focused on several key points including; publication and engagement on the strategic plan; producing an end of programme report; and lessons learned. A full end of phase one report would be submitted to the next meeting.

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

Verbal update by Chief Officer

Mrs Susan Manion updated the Health & Social Care Integration Joint Board members on the current status of the draft Scheme of Integration. She advised that a further revised version had been produced taking into account further legislation and guidance that had been received since March 2015. A second draft was due to be submitted to the Scottish Government for review by the end of October 2015.

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

Cllr John Mitchell and Cllr Jim Torrance left the meeting.

Verbal update by Communications Officer

MsCarin Petterson updated the Health & Social Care Integration Joint Board members on progress made in regard to the next newsletter for staff (tabled). It was intended to publish it more frequently and it was available on line and being distributed through email lists. Some hard copies had been printed and would distributed through the Strategic Planning Group networks to GP practices, care homes. etc.Mrs Karen Hamilton suggested quantifying what was required in terms of hard copies to ensure good budgeting. It was confirmed that there were enough available resources for hard copy publications to be produced.

Cllr John Mitchell and Cllr Jim Torrance returned to the meeting.

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

Director of Finance/Chief Financial Officer

Mrs Carol Gillie presented the exception report on the integration joint budget to the end of August 2015. She highlighted several points including: the budget for domestic abuse was still being identified; the budget for 15/16 was on an aligned basis; the projected year end position was an overspend of £388k linked to overspends on GP prescribing and dental services. The financial pressure on GP prescribing was linked to certain drugs being in short supply globally. The NHS had put in place contingency funds to support the overspend. She further reported a breakeven outturn in adult services despite a number of pressures as detailed within the report. As a result of remedial actions and Scottish Borders Council Executive having approved a virament of £300k to support some of the pressures the position was projected to breakeven.

Dr Stephen Mather enquired what would happen when the drugs budget outstripped any contingency funding and the year end position was an overspend? Mrs Gillie confirmed that both she and Mr David Robertson had continually tried to highlight how challenging the financial position would be. She commented that the draft Scheme of Integration was clear that in dealing with financial pressures the Health & Social Care Integration Joint Board would be expected to discuss what actions it could take to bring the budget back into line.

Mr Robertson commented that the mechanisms to deal with adverse variances at the year end had not yet been agreed.

Ms Tracey Logan commented that the whole purpose of the Health & Social Care Integration Joint Board was to improve the outcomes for the population by driving performance of the delivery of the delegated functions in a more efficient and effective way, whilst recognizing that it was the duty of all partners to deliver as much as possible in order to fund the growth if nothing else.

The Chair enquired if contingency funding would be put in place to deal with an overspend in the future. Mrs Gillie advised that the due diligence process was being worked through which would provide assurance on how contingency funding might be provided in the future. Mr Robertson advised that at Scottish Borders Council brokerage mechanisms were in place for accessing Council reserves as opposed to contingency funding and Mrs Gillie confirmed that brokerage mechanisms were not available to the NHS.

Further discussion focused on: contractors costs; non funding of drugs centrally; future delivery of more effective and efficient redesigned services; carers costs; due diligence and budget assumptions.

The HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD noted the report and projected year end overspend of £388k.

Chief Officer

Mrs Susan Manion highlighted the NHS Borders Winter Plan 2015/16 to the Health & Social Care Integration Joint Board members for their information, she tabled a revised cover sheet.

During discussion several key areas were raised including: working collectively across both social care and health; impact of delayed discharges on acute and social care services; planning ahead with home care providers; availability of equipment from the Joint Ability Equipment Store; home carer recruitment difficulties; use of intermediate care and flex beds; 7 day delivery of services; and joint reporting on delayed discharges. In regard to performance it was noted a more defined report would be submitted to a future Health and Social Care Integration Joint Board in line with the performance framework.

The HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD noted the NHS Borders Winter Plan 2015/16.

Chief Social Work Officer

Mrs Elaine Torrance presented her Annual Report to the Health & Social Care Integration Joint Board members for their information.

Cllr Frances Renton also highlighted the progress made in regard to inspections of care homes and adult protection.

The HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD noted the report and section 12 key challenges.

There was none.

Monday 14 December 2015 at 2.00 pm 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 14 December 2015 at 2.00pm in the Council Chamber, Scottish Borders Council.