Agenda item

Mrs Jill Stacey provided an overview of the content of the report and highlighted several elements including: audit work; risk register and zero new audit recommendations.

Mr John Raine enquired which particular concerns Mrs Stacey had in relation to governance arrangements.  Mrs Stacey advised that in the context of the organisation continuing to evolve her concerns were mainly around the distinction of the role of the Integration Joint Board (IJB) with partners and the IJB operating in that clearly defined role at a strategic level with partners delivering the operational services commissioned by the IJB.

Mr Raine enquired if the IJB was doing what it ought to be doing or if there were glaring deficiencies in how it was operating.  Mrs Stacey suggested it was a real challenge for the IJB to understand enough about the partnership organisations and how they operated and gathered assurance.  She suggested a key element of that was the Strategic Plan and commissioning and monitoring delivery of the strategic priorities.

Mr Raine noted that risk management was not yet fully embedded in the culture and suggested that itself was risk.  Mrs Stacey commented that Management colleagues had the responsibility for identifying the strategic risks within the partnership sphere.  She suggested the challenge for the IJB was to feel assured that there was clarity around strategic risks within the papers presented to it. The development of the strategic risk register for the IJB would assist with the flow of information into reports received by the IJB.

Mr Raine enquired if the IJB was too passive in terms of not testing out risk. Mr David Robertson suggested if the IJB looked at the difference in terms of delivery against outcomes, then it would continue to be a work in progress through the issuing of directions and ensuring both organisations were delivering against the strategic plan.  Mrs Stacey commented that there were a number of factors in the improvement action plan to come together and once they were joined it would provide the basis for the IJB acting in a more strategic way with regular scrutiny of how partners delivered against directions.

Mr Raine noted that the performance management framework was not fully developed and therefore could not be an effective mechanism to monitor service delivery.  Mrs Stacey commented that compared to the first year there had been a shift in the performance management framework which now covered a broader range of services and learning form other IJBs across Scotland would be useful going forward.

The Chair advised that at a recent meeting between COSLA and the Cabinet Secretary for Health & Sport, the Cabinet Secretary had advised that all the IJBs across Scotland were being reviewed and compared in order to provide best practice for IJBs to move forward.

The SCOTTISH BORDERS HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD AUDIT COMMITTEE noted Internal Audit annual opinion on the overall adequacy and effectiveness of the IJB’s framework of governance, risk management and control set out within the Internal Audit Annual Assurance Report 2017/18 as detailed in Appendix 1 of that report.