Agenda and minutes

1.1 Apologies had been received from Cllr D Parker, Elected Member, Mrs J Smith, Borders Care Voice, Ms L Gallacher, Borders Carers Centre, Mr R Roberts, Chief Executive, NHS Borders, Mr D Robertson, Chief Executive, Scottish Borders Council, Mr N Istephan, Chief Executive Eildon Housing, Mrs J Smyth, Director of Planning & Performance, NHS Borders, Mrs L Jones, Director of Quality & Improvement, NHS Borders, Mr A Bone, Director of Finance, NHS Borders, Mr B Davies, Chief Officer – Strategic Commissioning & Performance, SBC, Mrs S Bell, Communications Officer, SBC, and Mrs H Jacks, Planning & Performance Officer, NHS Borders.

1.2 The Chair welcomed Mr Simon Burt, General Manager MH&LD to the meeting who was presenting item 5.2 on the agenda.

1.3 The Chair confirmed that the meeting was quorate.

Members should declare any financial and non financial interests they have in the items of business for consideration, identifying the relevant agenda item and the nature of their interest.

2.1 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.

01.02.23

15.03.23

3.1 The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 1 February 2023 were amended at page 5, paragraph 6.5, line 3 to read “had pulled some of the funding …” and with that amendment the minutes were approved.

3.2 The minutes of the previous meeting of the Health & Social Care Integration Joint Board held on 15 March 2023 were approved

Action Tracker

4.1 The Chair confirmed that the 3 items discussed at the meeting on 15 March 2023 that required virtual approval via email outwith the meeting were: the 2022/23 IJB Financial Plan and Initial Budget; Evidencing compliance with the Equality, Human Rights and Fairer Scotland Duties; and Scottish Borders Health and Social Care Strategic Framework 2023-26.

4.2 The Chair formally recorded that all 3 items had been approved via email prior to the deadline of 31 March 2023.

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

5.1 Mrs Hazel Robertson advised that approval of the social care element of the budget had been requested at the previous meeting. At that point in time approval of the health care element had not been requested due to additional information being required. She was pleased to advise that she was now in the position of being able to seek approval for the full initial budget.

5.2 Mrs Robertson provided an overview of the report and highlighted the changes to the content of the report that had been made since the paper had been considered last. Specifically she drew the attention of the Board to: additional information regarding the estimated reserves position as a result of the earmarked allocations received by NHS Borders on the IJB’s behalf; the savings targets remained the same as in the previous version of the report however the level of savings required was significant across the partnership and the associated risk was high; the recommendation that a recovery plan be formulated to address the level of risk in the budget for the IJB to consider at its meeting in May; and using the recovery plan to cover a quarter of the allocated gap currently found in the budget.

5.3 Mrs Robertson also noted changes in the budget in section 4, and highlighted that: the Mental Health and Learning Disabilities line in the table had been adjusted for the non-inclusion of external commissioned services; and that Home First was included in the generic line of figures of £13m; and in regard to the National Care Home contract at paragraph 5.6, the narrative had been expanded in regard to the uplift to the contract which remained under negotiation.

5.4 Mrs Robertson explained that the recovery plan process and recovery would not be possible in one year and would require to be linked to the medium and longer term financial strategy. She suggested an approach across the partnership whereby the Integration Joint Board (IJB) and Scottish Borders Council (SBC) and NHS Borders had a financial model to look at the longer term period with a view to achieving financial balance. In regard to risk she highlighted the insufficient funding for the Primary Care Improvement Plan (PCIP) and the need to continue to seek a funding stream that would ensure the work programme could be taken forward.

5.5 Mrs Karen Hamilton welcomed the report, and understood the stresses and constraints surrounding its collation. She also welcomed the progress made in the reconciliation between the partners to ensure there was a better understanding of where the savings targets might sit. She also supported its approval as an initial partnership budget.

5.6 Dr R Mollart commented that it would be helpful if the report would capture the risk for PCIP and thanked Mrs Robertson for alluding to that in her explanation. The Chair agreed the inclusion should be noted in the next version of the report.

5.7 Mr Chris Myers commented that the IJB followed local government finance regulations which meant  ...  view the full minutes text for item 5.

6.1 Mr Simon Burt provided an overview of the content of the report and highlighted: the Gala Resource Centre (GRC) was a day service for adults with mental health problems which was building based in Galashiels; it had been temporarily closed since 2021; previous service users had either completed their course of treatment or had been referred to other appropriate services; since its inception there had been a process of ongoing service modernisation to develop a range of alternative services to enhance the quantity of support to adults experiencing mental ill health issues; formation of the renew service; the introduction of Miller House; short term interventions; wellbeing college; and the local area intervention service.

6.2 Mr Burt assured the Board that as a result of the additional support available there were no negative impacts identified for service users on the closure of the GRC and a comprehensive equalities impact assessment had been carried out. He emphasised that the new services provided an improved equity of services. He also commented that the closure of the GRC would contribute roughly £167k towards off setting cost pressures across the mental health services budget.

6.3 The Chair welcomed the comprehensive document and clear recommendation.

6.4 Mrs Karen Hamilton enquired if the proposal would lead to any impact on waiting times, either positive or negative. Mr Burt advised that the closure of GRC would not impact on waiting times in a negative way and the biggest challenge for mental health services waiting lists was the Child and Adolescent Mental Health Service (CAMHS) which would not be impacted by the closure.

6.5 Mr Tris Taylor thanked Mr Burt for the detailed equalities impact assessment and commented that it was helpful to see the outcomes with timelines as well as the governance arrangements.

6.6 Mr John McLaren requested clarification in the equalities impact assessment and enquired if the cross meant it had been considered or was not an impact. Mr Burt thanked Wendy Henderson for her help with the equalities impact assessment and explained the process followed. He commented that in terms of people with disabilities there would be no adverse impact on those individuals if the change were to occur and actually there would be a positive impact since the building in Galashiels was not accessible to people with disabilities whilst the services now provided had more accessibility for people with disabilities.

6.7 Dr Rachel Mollart welcomed the suggestion of a reinvestment into an emotional and unstable personality disorder service, which was a service that GPS had been asking for. If the reinvestment was agreed she suggested it might be possible to link it to the renew service and PCIP and she asked that any such service proposal be submitted to the GP Sub Committee for discussion.

 6.8 Dr Lynn McCallum suggested the discussion on emotional and unstable personality disorder service be taken outwith the meeting as she was keen to discuss it with the mental health and psychology teams before a discussion was had at  ...  view the full minutes text for item 6.

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted there was none.

Wednesday 17 May 2023

10am to 12pm

Scottish Borders Council and via Microsoft Teams

8.1 The Chair confirmed that the next meeting of the Scottish Borders Health & Social Care Integration Joint Board would be held on Wednesday 17 May 2023. She requested that as there was a newly scheduled meeting of all Chairs of Integration Joint Boards with the newly appointed Cabinet Secretary at 11am that morning, that the IJB meeting be held from an earlier start time of 9am via MS Teams only to allow her to attend the Cabinet Secretary meeting.

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD agreed to the revised meeting arrangements.