Agenda item

Mr Robert McCulloch-Graham gave an overview of the content of the report and highlighted the preparation of the primary care improvement plan; Day of Care Audit (DoCA) across all community hospitals and some of the wards within the Borders General Hospital; joint winter plan progress; regional work in regard to Diabetes; Child and Adolescent Mental Health Services (CAMHS) performance; older people’s inspection progress and Buurtzorg.

Mr John McLaren enquired if the impact of the CAMHS decision on the service was fully understood. Mr McCulloch-Graham advised that the drop in performance was unusual and had been attributed to a failure to recruit to key posts within such a small service. To address the situation interim appointments had been made, succession planning explored, isolated what the issues were and pushed forward with driving up the changes needed. In regard to the IT issue, additional help had been provided to ensure such a situation did not happen again.

Mr Tris Taylor enquired if the facility of an audit should be used more frequently as a driver for change. Mr McCulloch-Graham advised that the DoCA was a regular event involving multi disciplinary professionals which gave a rounded view of the patient, their pathway and destination and provided a springboard for change. Mr Taylor enquired if there were other areas where the initiative could be utilised. Mr McCulloch-Graham advised that there were already detailed areas identified under the 3 objectives within the Strategic Plan to undertake such an initiative.

Mr Taylor enquired about the status of CAMHS in regard to the Integration Joint Board (IJB). Mrs Tracey Logan advised that whilst CAMHS was not a delegated function to the IJB it was part of the mental health service and the performance was presented to the IJB for information. Mrs Jane Davidson commented that Mr McCulloch-Graham was the operational Director in charge of Mental Health services overall and an improvement plan had been put in place.

Mr Colin McGrath suggested that in his opinion the Locality Working Groups were being ignored in favour of Areas Partnerships and he also suggested as finance was not a subject discussed at the Locality Working Groups the whole integration agenda was not working. He advised the IJB that he had been re-elected as the Chair of the Community Council Network and attended both Locality Working Group and Area Partnership meetings.

Mr McCulloch-Graham refuted the suggestion that integration was not working and advised that Scottish Borders Council and NHS Borders worked together through the formation of locality working groups to formulate local plans that were then shared with the Area Partnerships. Cllr Shona Haslam commented that Mr McCulloch-Graham was a regular attendee at the Area Partnerships and took a lead role in discussions on health and wellbeing. She suggested if there were any concerns being raised by the localities then they would be fully explored in the next round of engagement.

The Chair enquired if the Professor John Bolton work would be revisited and Mr McCulloch-Graham confirmed that it would be.

The Chair enquired it if was an appropriate time to revisit Buurtzorg. Mr McCulloch-Graham commented that there had been a recent visit from the Scottish Government to the Berwickshire area as a pre-empt to a future visit by the Cabinet Secretary. Buurtzorg was in the early stages and the proposal before the IJB under the Integrated Care Fund paper later on the agenda was to extend the Hospital to Home initiative in order to mainstream the initiative and create more grip in the system.

Mr John McLaren suggested the model being formulated locally was not strictly the Buurtzorg model as not all of that model could be replicated and he suggested giving it a different name. Mrs Davidson commented that the principles of Buurtzorg went beyond what the Buurtzorg model could do with health and home care and a stock take of where the current project was needed to be taken, so that the IJB could see what the community model was. She advised that liaison was taking place with the new Cabinet Secretary’s Office in regard to a future visit and in the meantime Health Improvement Scotland were filming a video to capture the work achieved to date.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD noted the report.