Agenda item

Mr Robert McCulloch-Graham introduced the Financial Plan presentation.

Mr David Robertson provided an informative presentation that was intended to reflect the paper. During the presentation Mr Robertson covered the full range of financial elements, including: strategic context; flow of funds; achievements the partnership had made; operational context; budget movement; Integrated Care Fund; Social Care Fund; efficiency savings and pressures for 2018/19.

Cllr David Parker sought confirmation that conditions around the implementation of the living wage and Carers Act were calls that would be directed to be fulfilled through social care funding.

Mr Tris Taylor enquired about the split of funding when resourcing joint services, such as a 1.5% increase in funding for the Mental Health Service given the 2018/19 budget was smaller than the 2017/18 budget. Mr Robertson advised that there was an expectation that NHS resources would stay the same. Mrs Carol Gillie confirmed that in moving forward there was a commitment in the NHS allocation letter baseline for 2017/18 compared to 2018/19. Some efficiencies had been delivered in the Mental Health Service which had enabled the 1.5% uplift from the NHS, which Mrs Gillie advised was in effect an allocation rather than an actual.

Mr Colin McGrath enquired of the overall proportion of the NHS budget in the partnership. Mrs Gillie advised that 52% of the NHS budget was transferred to the partnership. Mr Robertson also advised that 100% of the social services budget for all adult services was allocated to the partnership.

Mr Taylor enquired about the ring fenced funding received from the Scottish Government. Mr Robertson advised that ring fenced funding had been received based on future projections which had been estimated in good faith, however the funding did not fully cover the costings and there were therefore pressures to be addressed.

Ms Lynn Gallacher commented that she was aware that the Carers Action Plan implementation monies had been allocated around the various areas and she enquired where the Carers Information Strategy funding currently sat given it was not new money. Mr Robertson advised that there was a proposal to be put before the Strategic Board and a recommendation would be submitted to the Integration Joint Board meeting in June for decision.

Cllr David Parker commented that he understood some funding for the Carers Act payable to the Borders Carers Centre and was already mainstreamed, and he was aware that there were some things requiring payment as they involved salaries for people. Mr Robertson suggested if the Board were not minded to set the budget that day then it would be appropriate for the Board to take the decision to continue to fund certain areas at the discretion of the Chief Officer in conjunction with the Chair and Vice Chair of the Integration Joint Board.

In regard to efficiency savings, Mr McGrath enquired if services were given direction on where to make savings. Mrs Tracey Logan commented that services were made aware of the challenges and pressures within the Council and were asked to formulate proposals for savings. Proposals were assessed corporately and all dependencies were looked at through a fully rounded process before any recommendations were made. She stated that far more proposals were rejected than taken forward.

Mrs Claire Pearce noted that there had been a 30% occupancy rate at Craw Wood given the acuity of people had made them unsuitable to transfer to the facility from the acute sector and she enquired if 15 beds was an appropriate number. Mr McCulloch-Graham commented that funding had been agreed for 15 beds in total and the most used at any one point in time had been 14 over the winter period. He anticipated that demand would reduce during the summer and was mindful that a reduction in beds over that period might be appropriate, however he was keen to ensure the full compliment were maintained for the winter period. Mrs Pearce noted the high cost of maintaining 15 beds when only 5 were occupied. Mr McCulloch-Graham suggested retaining the resource allocated and keeping the number of beds under review with an ability to flex them as and when necessary.

Mrs Jane Davidson suggested the crucial point was to maintain flexibility throughout the year.

Cllr Helen Laing enquired if the right criteria were in place for Craw Wood. Mrs Logan reminded the Board that Craw Wood was a temporary unit and was restricted in terms of its use and she would support a reduction in beds when appropriate.

Mr Taylor sought clarification on the status of the financial plan. Mr McCulloch-Graham commented that the report was requesting that the Board note the financial gap and request a paper be brought back in June on how that gap would be addressed.

The Chair sought confirmation that the resource allocations were actual. Mrs Gillie confirmed that they were.

Cllr Parker sought clarification that certain business as usual activity would still progress such as the carers issue, staffing costs and looked for reassurance from Mr Robertson that those things would not be suspended until a decision was made by the Board in June. Mrs Logan confirmed that business as usual activity would continue.

Cllr Parker challenged if the Integration Joint Board was allowed to agree a budget that was not fully funded. Mr Robertson clarified that the Board could accept the report and on the recommendation of the Chief Officer ask for a future report to be brought before the Board in terms of the budget. He recommended that the Board accept the report, note the deficit in the budget and ask for a report from NHS Borders in June to detail how the funding gap would be bridged before final approval of the budget.

The HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD accepted the report on the 2018/19 Health and Social Care Financial Plan and asked that a report be brought to the June 2018 meeting with details of how the unidentified savings requirement would be addressed, recognising that plans to deliver £5.2m of savings remain unidentified.