Scottish Borders Council

Agenda item

NHS in Scotland 2020 (Auditor General / Audit Scotland)


Mr Asif Haseeb provided an overview of the report prepared by the Auditor General on the state of the NHS. He advised that the report was a summary of the individual NHS Board audits that had been undertaken. The report highlighted the impact of the pandemic in 2020 which had forced change in many areas and services. He clarified that the recommendations within the report were mainly for the Scottish Government or the Scottish Government and Health Boards jointly.


Mr Graeme Samson spoke to the key messages in the summary section and advised that the report mainly focused on; the pandemic; the challenges the pandemic presented; the NHS response to the pandemic; demands on services; test and protect; and the impact on local communities.


The Chair commented that in terms of an integrated workforce, by its nature the document was health based whereas it would be more meaningful if it included local authority data. She further wished to assure the Committee that NHS Borders had refreshed its pandemic plan in light of the COVID-19 Pandemic, as the previous pandemic plan had been based on a flu pandemic.


Cllr Tom Weatherston commented that across Europe, people in deprived areas appeared to be more impacted by the COVID-19 pandemic than in other areas, and he enquired if people were generally unhealthier in those areas. He further enquired about the impact of the withdrawal of free Personal Protective Equipment (PPE) across Health and Social Care from June 2021.


Mr Rob McCulloch-Graham commented that the pandemic had exacerbated inequalities, which was most evident in deprived communities where people were living in close proximity to each other, shared often overcrowded public transport and were more likely to be low paid workers. He advised that whilst protection controls were in place they were difficult to enforce and there were some outbreaks in areas of deprivation in the Borders.


In regard to PPE he commented that he did not know what the solution would be as it was highly likely that there would be a continued need for PPE into 2022 and possibly beyond.


Chief Officers of IJBs across Scotland were keen to understand the next stage in regard to PPE provision and he would feedback to the Committee once that position was clarified.


Ms Sonya Lam suggested the recommendation that the Scottish Government and Health Boards monitor and report on staff wellbeing (page 22, point 23), should include social care staff so that learning could be shared across the systems. The Chair welcomed the suggestion.


Mrs Jill Stacey reminded the Committee that the Internal Audit recommendations for 2019/20 had highlighted the need for a refresh of the workforce strategy in order to align it with Scottish Government reporting on integrated workforce planning. The Strategic Planning Group had also requested that the Joint Staff Forum refresh its Terms of Reference and she suggested an update on workforce be provided as part of the annual reporting cycle.


The Chair welcomed the opportunity of brining all the strands of workforce together across the organisations and the suggestion of an update to a future meeting.


Mr McCulloch Graham commented that the pandemic had been instrumental in forcing the integration of the workforce over the previous 12 months. He was keen to further merge the senior governance of the IJB, Scottish Borders Council (SBC) and NHS Borders given the explicit focus of the IJB on commissioning and strategy. There may also be further integration if all or some of the recommendations within the Derek Feeley report were accepted by the Scottish Government.


Mr Jim Wilson enquired about the current situation with vacancy rates and the use of agency staff. Mr McCulloch-Graham advised that during the pandemic staff had been redeployed into different professions both within NHS Borders and SBC, as the organisations were now remobilising their services staff were being moved back to their substantive roles and the use of agency staff had begun to increase.


The SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATION JOINT BOARD AUDIT COMMITTEE considered whether there were any actions arising from the national report for SB IJB that needed to be referred by the IJB Audit Committee to the IJB Board.

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