Agenda and draft minutes

Apologies had been received from Cllr Robin Tatler, Mrs Harriet Campbell, Non Executive, Ms Juliana Amaral, BAVs, Dr Lynn McCallum, Medical Director, Mr Andrew Bone, Director of Finance, NHS Borders and Mrs Jenny Smith, Borders Care Voice

The Chair welcomed Mrs Hazel Robertson to her first meeting of the Integration Joint Board (IJB) in her official capacity as Chief Financial Officer of the IJB.

The Chair to welcomed a range of attendees to the meeting.

The Chair confirmed the meeting was quorate.

15.06.22

The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 15 June 2022 were approved.

Action Tracker

Action 2021-6: Mr Myers confirmed that the action remained on-going.

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

Mrs Cathy Wilson provided an overview of the content of the paper and highlighted several key elements including: work on skill mix; scrutiny of workforce to validate the workforce required; £200k savings achieved; future funding envelope insufficient for the development of Memorandum of Understanding (MoU) 2; and recurring funding required to TUPE staff from GP Practices.  Mr Hazel Robertson elaborated on the content of the allocation letter and its implications for the IJB. She advised that the IJB would be required to ensure it fully spent any carry forward balances within its reserves. Then 70% of the allocation would be released to the IJB with the remaining 30% held in abeyance. She further advised that the funding envelope did not give certainty for the next year, but gave some indication of an overall direction of travel.  Dr Kevin Buchan commented that the organisation was in a reasonably good position as it had continued to work on elements of the PCIP through the COVID-19 Pandemic. He advised that the consequences of not delivering the contract were huge and suggested that there would be significant difficulties with GP Practices in the Borders being unable to provide their normal high level of care. Mrs Kathy Steward commented that as the clinical lead for CTAC, explained that there were lots of dependences in the project and in terms of timescales they were already part way through the organisational change process with current staff, vacancies would require to be recruited to as well as the TUPE of staff. There would be pressures to deliver CTAC by the end of March, however she suggested the IJB should consider the risks of non delivery.  Discussion focused on: what was the level resource predicted on a recurrent basis from April 2023; what was the acceptable level of risk given a lack of available funding; supported the direction of travel; Scottish Government had responsibility for financially resourcing the PCIP; escalation of the overall position to the Scottish Government to make them aware of the implications of non delivery of MoU 2; assurance to NHS Borders that the IJB will commission what it has funds to commission to ensure it does not operate an overspend position; sustainability payments; position of ring fenced reserves; any direction should clearly set out the risks and assumptions made by the IJB; and pursue a more robust approach with the Scottish Government on future funding.  Cllr David Parker commented that non recurrent resources should not be used to TUPE staff and clarification of the financial situation was required.  Mr John McLaren enquired about the level of engagement that had taken place with the Scottish Government.  Mr Tris Taylor expressed concern that the IJB did not have clarity on the financial risk and that the operational risks required to be summarised.  In terms of the financial risk, Mr Chris Myers advised that he had written to the Director of Primary Care at the Scottish Government and outlined the situation and advised that there  ...  view the full minutes text for item 4.

-     Potential to pilot as local test of change for the NCS (letter to SBC and NHS Borders)

Mr Chris Myers provided background information to the item and the engagement process that had been followed in order to develop the response. He spoke of the content of the response and suggested that for co-terminous areas and remote and rural areas it could have a significant impact on the delivery of services that were currently operating. The response noted that that Feeley Review had put people at the centre of their care, however the Bill was focused on structures and did not elude to what it could do for people. The Chair noted that there were 3 separate responses formulated which would be discussed and submitted from the IJB, Scottish Borders Council and NHS Borders. She suggested the option of a pathfinder would be the opportunity to formulate something that would fit with the uniqueness of the Scottish Borders rather than having something imposed that may not meet the needs of the Scottish Borders.  Mr John McLaren commented that he was concerned that being a pathfinder would add further pressure and stress onto an already fragile workforce.  Mr David Bell echoed Mr McLaren’s comments and reminded the Board that the organisations all struggled to retain staff and further pressure on staff could potentially exacerbate that position further. Further discussion focused on the pros and cons of being a pathfinder.

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD considered the response developed.

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD did not provide any further comments.

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the response for submission to the Scottish Parliament’s ‘Call for Views’ and ‘Your Priorities’ consultations.

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed (by a majority at the meeting) to the principle of progressing discussions with the Scottish Borders Council, NHS Borders and Scottish Government to explore the potential for a local pathfinder to support the development of the Bill.

Wednesday 21 September 2022

10am to 12pm

Microsoft Teams

The Chair confirmed that the next meeting of the Scottish Borders Health & Social Care Integration Joint Board would be held on Wednesday 21 September 2022, from 10am to 12noon, via Microsoft Teams.