Agenda and minutes

1.1 Apologies had been received from Mr J McLaren, Non Executive, Ms L Jackson, LGBTQ+, Ms L Gallacher, Borders Carers Centre, Mr R Roberts, Chief Executive, NHS Borders, Mrs J Smyth, Director of Planning & Performance, NHS Borders, Mr D Bell,Staff Side, SBC, Mrs J Smith, Borders Care Voice, Mrs Y Smith, Partnership, NHS Borders, Dr S Bhatti, Director of Public Health, NHS Borders and Mrs L Jones, Director of Quality & Improvement, NHS Borders.

1.2 The Chair welcomed attendees and members of the public to the meeting including Ms Wendy Henderson, Scottish Care, Ms J Holland, Director of Strategic Commissioning & Partnerships, SBC and Mr David Knox, BBC Scotland.

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.

19.04.23 EO

3.1 The minutes of the Extraordinary meeting of the Health & Social Care Integration Joint Board held on 19 April 2023 were approved.

(a)        Action Tracker

(b)        Direction: Hawick Care Village

Direction: Hawick

5.1 Mr Chris Myers detailed the updates to the Direction and advised that the Strategic Planning Group were fully supportive of the revised direction.

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD approved the Direction for issue.

a          Direction: Teviot & Liddesdale Day Service Business Case

a(i)       Appendix 1

a(ii)      Appendix 2

a(iii)     Appendix 3

a(iv)     Appendix 4

6.1 Mr Chris Myers provided an overview of the report and spoke about the engagement process undertaken. He highlighted several areas including: NDTi; unpaid carers; and options appraisal results.

6.2 Cllr Neil Richards enquired about the number of providers identified. Mr Myers advised that 6 providers had responded with expressions of interest however only 1 provider had completed the submission process. He suggested there were a range of difficulties for providers in terms of recruitment, provision of a day service only, economies of scale and geographical area that were barriers for providers.

6.3 Mr Tris Taylor enquired about financial evaluation and commented that carer burnout was mentioned in the Inequalities Impact Assessment. He suggested there should be more understanding of quantifying the wider benefits in financial terms in the future.

6.4 Mrs Hazel Robertson advised that the best practice model had been followed for the options appraisal with additional value considerations. The preferred option was considered to be a better value model as more would be supported by the service. She suggested she would give more thought on how to undertake value consideration in future cases.

6.5 Cllr Elaine Thornton-Nicol enquired about the number of days to be supported. Mr Myers confirmed that it would be a 5 day service for those with dementia and other needs who were older adults. If the demand increased due to population change there would be the option to consider commissioning more capacity.

6.6 Mr Myers commented that in terms of the Newcastleton area, level of demand was low and appropriate options would be considered for those residents to promote social interaction and respite support. Z

6.7 The Chair enquired about the modelling numbers. Mr Myers commented that the service would accommodate 14 people per session. There were already 20 people receiving replacement care in Hawick and he anticipated that the service would be highly occupied across all 5 days.

6.8 Dr Rachel Mollart suggested a comparison to other areas. Mr Myers commented that it had been agreed based on the legal decision from the Court of Session that the greatest need was for the Hawick area and then for the Eildon area. A review of the care provision in other localities would also be undertaken.

6.9 Cllr Thornton-Nicol enquired if the service was affordable and of the likelihood of there still being unmet need in 5 years time. Mr Myers commented that the approach had been reflected upon and in order to do it well and in line with the legal obligation it had to be undertaken locality by locality with impact assessments carried out at a locality level.

The SCOTTISH BORDERS HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD approved the selection of the preferred option based on the definition of the required service and the qualitative and financial options appraisal carried out.

The SCOTTISH BORDERS HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD approved the Business Case and the associated Direction.

The SCOTTISH BORDERS HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD approved  ...  view the full minutes text for item 6a

Direction: Proposal to implement a further Night Support / Rapid Response Pathfinder in the Duns area.

7.1 Mrs Jen Holland provided an in-depth narrative of the content of the report which summarised the process and findings of the consultation.

7.2 Discussion focused on: the current provision of an overnight service in Peebles; provision of the overnight service in Duns; overnight continence provision; feedback from service users in Peebles; rapid response team overnight provision; palliative and end of life care will not be affected; negative responses to the initial pathfinder; other overnight services include the District Nursing Twilight service and overnight BECs (Borders Emergency Care); and embedding of lessons learned in future consultations.

7.3 Mrs Karen Hamilton sought clarification on the “tech” used. Mrs Holland commented that it included systems such as bed sensors and door sensors.

The SCOTTISH BORDERS HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD reviewed the findings of the consultation.

The SCOTTISH BORDERS HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD approved the approach to undertake a further test of change followed by consultation in the Duns area.

c                Direction: Strategic Approach to Relaunch Locality Working Groups (Community Integration Groups).

c(i)            Appendix             

8.1 Mr Chris Myers explained the background to and content of the direction.

8.2 Cllr Elaine Thornton-Nicol reminded the Board that Eildon was a large area made up of 3 wards and she enquired how those with lived experience and unheard voices would be included in the Locality Working Groups.

8.3 Mr Nile Istephan suggested the governance might be light as he was keen to understand how any tensions between the Locality Working Groups (LWG) and the Strategic Planning Group would be resolved.

8.4 Mrs Karen Hamilton echoed Mr Istephan’s comments and sought a strengthening of governance through a suggested tree of responsibility diagram. Whilst supportive of the proposal she suggested a smaller area as the first locality may have been preferable given the area of Eildon included 3 separate wards.

8.5 Mrs Hazel Robertson commented that in order to assist people to join their LWG and to support them to access it, an expenses policy would be formulated.

8.6 Mr Myers commented that Eildon was the largest and most complex area for a LWG and part of the reason for starting in Eildon was to understand the complexities and intricacies of a large locality before LWGs were rolled out elsewhere. In terms of lived experience and unheard voices, consideration was given to that through the Stage 1 IIA and is being further progressed through Stage 2 of the IIA to ensure a broad representation of society is engaged and involved in the LWG.

The SCOTTISH BORDERS HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD approved the strategic approach to re-launch Community Integration Groups (Locality Working Groups) outlined in the paper.

The SCOTTISH BORDERS HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD agreed to commission a pathfinder in the Eildon locality to inform the future development of the approach.

The SCOTTISH BORDERS HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD agreed to review the initial findings from the pathfinder in the September 2023 meeting.

a                Integrated Workforce Plan

a(i)           Equality Outcomes 5 & 6

a(ii)          IWP Progress Report

a(iii)         Implementation Board Membership

9.1 Mrs Wendy Henderson provided an update on the actions taken since the last update provided to the Board in March 2023. She commented that the equality and mainstreaming actions had been adopted and incorporated into the action plan for the Implementation Board and outcomes were starting to influence and inform discussions. 9.2 The Chair enquired why medication management was a workforce item. 9.3 Dr Rachel Mollart commented that Dr Tim Young was no longer a practicing GP and sought the nomination of a GP from either GP Sub Committee or LMC to join the group. 9.4 Mrs Fiona Sandford welcomed the paper and cautioned that an over success in increasing the threshold for salaries for skilled workers could lead to gaps in the care sector. Cllr Robin Tatler left the meeting. 9.5 Mrs Sarah Horan on the point of medication management commented that separate employers working in partnership had different regulations and rules. She enquired how the end user could be placed at the centre of provision. 9.6 Mrs Henderson commented that medication management was in regard to the prompting or administering of medication. It was one of the top 3 areas for improvement in the delivery of care and transition of care from hospital to home or to the care sector. The SCOTTISH BORDERS HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD noted the progress made to date. The SCOTTISH BORDERS HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD agreed to accept update reports at the IJB meetings to be held in January, May and September of each year.

The SCOTTISH BORDERS HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD noted the contents of the Directions Tracker

19.12.2022

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the minutes

01.02.2023

The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the minutes

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

Wednesday 19 July 2023

10am to 12pm

Scottish Borders Council and via Microsoft Teams

14.1 The Chair confirmed that the next meeting of the Scottish Borders Health & Social Care Integration Joint Board would be held on Wednesday 19 July 2023, from 10am to 12noon through MS Teams and in person in the Council Chamber, Scottish Borders Council.