Agenda item

Presentation by Chief Officer Health and Social Care Integration to provide Members with a greater understanding on how the Health and Social Care Integration Joint Board is delivering its Strategic Plan to improve the lives of Borderers and meet the growth demands in the Care Sector.

10.1     With reference to the Scrutiny Work Programme 2018/19, the Chairman welcomed Mr Rob McCulloch-Graham, Chief Officer Health and Social Care Integration to the meeting to provide Members with a greater understanding on how the Health and Social Care Integration Joint Board was delivering its Strategic Plan to improve the lives of Borderers and meet the growth demands in the care sector.  Mr McCulloch-Graham began by identifying the challenges facing the service which included an increase in the population in the Borders, an increase in the complexity of cases being presented and a reduction in available resources.  These, in turn, resulted in more people accessing Primary Care (GPs) and presenting at hospital; admissions being more complex and therefore remaining in hospital for longer; more care at home being required; and more care home places being needed.  Mr McCulloch-Graham went on to show how integrated services were provided and funded under the headings of Community Health Services, Acute Health Services provided in a hospital, and Adult Social Care Services.  Mr McCulloch-Graham explained the governance of the IJB and how funding under Delegated Funds and Set Aside Fund was allocated differently at a local level in the Scottish Borders and nationally, an example being that Palliative Care might or might not be included in this Set Aside Fund.  He further explained that work undertaken in 2013/14 determined due diligence as to how much would be allocated to the Set Aside Fund and that any savings required from within this required direction from the IJB.  There was an increasing pressure to manage the demand on services and Mr McCulloch-Graham identified some of the ways in which this was being addressed.  Longer GP/surgery opening hours with more facilities to carry out diagnostics and procedures and multi-professional teams operating within GP clusters would reduce the pressure on the acute sector; and providing wider access and support to individuals to lead a healthy and active life would result in a healthier population overall.  The SBC Community Plan and five Locality Plans which had already been introduced promoted these aims.  Mr McCulloch-Graham explained that following a visit to a GP, there was a range of pathways that did not necessarily point to acute procedures, eg physiotherapy, access to mental health service, pharmacy etc.  When hospital admission was required, then the aim would be for quick admission and discharge with all agencies being aware of what was required for a safe discharge. This could include measures such as existing care packages being held over during the period of admission; ensuring that equipment was installed prior to discharge; hospital to home services informed and ready for discharge; and transport arranged to take the individual back home which had been readied for their return.  The IJB had already introduced a strategy for Re-Ablement where individuals were discharged from hospital for assessment prior to returning home and further, additional services at home and within communities would also help prevent readmission.  Mr McCulloch-Graham advised that admissions to Craw Wood had been very successful with the average stay lasting 9-10 days.  He added that the provision of beds would fluctuate according to need, eg during winter.  There was a need to maintain the flow of people from hospital to home at a manageable level and it was therefore essential to deliver the right services in the right place at the right time.

10.2     Members raised a number of questions.  Mr McCulloch-Graham acknowledged that there were issues in terms of service provision and funding to be addressed in relation to the physiotherapy service across the area and advised that these concerns would be considered in July 2018.  He also advised that a survey was being carried out to identify what was required in terms of dementia and Alzheimer’s diagnosis and care within the Scottish Borders.  Further discussion followed in relation to any future savings that might be required and it was agreed that an update would be presented to the Committee in nine months.  The Chairman thanked Mr McCulloch-Graham for his attendance and presentation.

            DECISION

            (a)        NOTED the presentation.

            (b)       AGREED to receive an update report in January 2019.