Agenda item

Mr Robert McCulloch-Graham gave an overview of the conditions attached to the transfer of the Integrated Care Fund from NHS Borders to the Integration Joint Board.

Mr Tris Taylor advised that he was concerned about accepting conditions for budgets from partners who the Integration Joint Board were then to commission services from.

Mrs Carol Gillie advised that from an NHS perspective, the Health Board received funding from the Scottish Government and then decided how much it would provide to the IJB aligned to the detail within the legislation. In regard to the Integrated Care Fund (ICF) that had been a 3 year fund that ended at the end of the last financial year and NHS Borders had agreed that it would ring fence funding to provide some additional resource to the IJB to do certain things and the conditions were what the Health Board wished the IJB to do, as well as accept that it was non recurring ring fenced funding. She advised that should the IJB accept the conditions then it should commission something in line with those conditions from health or other providers.

Mr John Raine suggested the conditions were reflective of the priorities of the IJB and should not be seen as setting a precedent.

Mrs Tracey Logan advised that from a Local Authority perspective she had concerns as she did not think they had the same interpretation of the transfer of monies as Mrs Gillie had set out. She suggested that whilst the partners might agree with the priorities for the IJB there could be other actions to be taken to support the desired outcome but where funding would need to be directed to actions not necessarily compliant with conditions 1 and 2.

Cllr Shona Haslam suggested amending the conditions.

The Chair reminded the IJB that it had made the view the previous year to make the main thrust of business to reduce Delayed Discharges and progress on that front was being made along those lines and the conditions reinforced that position, however he reflected that reducing delayed discharges may not be commensurate with reducing costs.

Karen Hamilton left the meeting.

Mrs Jenny Smith commented that the third sector would have welcomed the opportunity at an earlier stage to inform some the criteria as the conditions at points 1 and 2 would not necessarily lend themselves to the prevention work that the third sector was involved in.

Cllr Haslam commented that the discussion was about criteria and not conditions and it was semantics and in suggesting slight changes to make the conditions more generic did not suggest a focus would not be given to delayed discharges and occupied bed days as they would continue to be priority areas for het IJB.

Mrs Gillie reminded the IJB that it was a 1 year fund only.

Mrs Logan commented that by attaching specific conditions to the funding there would be an impact on the social work part of the budget, as when delayed discharges were reduced they were pushed to social work and the third sector end of the budget. She suggested the fund be about having more efficient outcomes and by making the conditions more generic no agencies would be penalised.

Mr McCulloch-Graham advised that the next set of ICF projects impacted on delayed discharges and if there was a delay in approval it would lead to further delays in action and he suggested to be pragmatic and did not disagree with any of the discussion. He suggested a decision required to be made to drive down the current pressures in the system and if we look at the changes suggested by Cllr Haslam he could provide reassurance that all the proposals did have an impact on delayed discharges and if there were changes made to the conditions then he would suggest accepting the conditions for that one year funding to see the IJB through the winter period and a renegotiation of conditions for any funding that might be supplied from the Health Board the following year.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD accepted the proposed conditions for the 4 projects to be discussed at the next agenda item.

The HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD suggested Mr Robert McCulloch-Graham and Dr Stephen Mather find a form of words appropriate to asking the Health Board to reconsider the conditions for the remainder of the non-recurring 1 year fund.