Agenda item

5.1 Mrs Hazel Robertson provided an overview of the content of the report and explained how the IJB and Health & Social Care Partnership (HSCP) budget was compiled through offers from Scottish Borders Council (SBC) and NHS Borders. The process had been revised to formalise the sign off of the budget with both SBC and NHS Borders. The NHS Borders position was complex and formal sign off of that element would be sought at the next IJB meeting. However the SBC positon was less complex and she confirmed that the information provided by SBC met the requirements for setting the IJB budget.

5.2 Mrs Robertson commented that there had been a substantial historical savings target within the IJB budget and she anticipated that remaining in place with an increased requirement for savings in order to reach a balanced position for the partnership. She reiterated that the process with NHS Borders had not yet concluded and it was important to rectify that position in order to produce a recovery plan to show how those savings targets would be met. Whilst it was a difficult budget to work with she now had clarity of the issues and the funding to be set aside as the budget for next year remained consistent.

5.3 Mrs Robertson then detailed the budget proposals.

5.4 Mrs Fiona Sandford welcomed the report which was very clear in its layout. She enquired about the table in section 8.1 as it did not detail an entry against Home First. She also enquired if the level of savings was in line with other IJBs across Scotland.

5.5 Mrs Robertson advised that she would check the detail of Home First and respond outwith the meeting. Mr Andrew Bone suggested that the Home First information had been included in the “generic services” line but advised he would clarify the positon to Mrs Robertson.

5.6 Mrs Robertson commented that in regard to other IJBs she would gather some benchmarking information to be shared at the next meeting.

5.7 Mrs Jenny Smith echoed Mrs Sandford’s compliment in terms of the layout and content of the report. She commented that in her role as third sector member of the IJB it was a challenge to understand the finance and savings plan as they were high level and without the detail it was hard to make an informed decision. She suggested moving forward that they be involved earlier in the process. Mrs Robertson commented that she was keen to pursue the best value for every £1 approach in a number of areas and sought Mrs Smith’s involvement in that process. Mrs Smith welcomed the opportunity to be involved.

5.8 Dr Sohail Bhatti welcomed the clarity in the budget paper and enquired about the starting point when needing to decrease resource. He quoted Professor Rose of GlaxoSmithKlein about the vast majority of drugs only working on 30%-50% of people due to genetic factors. He suggested there was progress to be made with the drugs budget and getting the public to be fitter and healthier and manage self care with confidence. He also welcomed the programme budgeting pathway.

5.9 On a point of clarification Dr Rachel Mollart questioned the PCIP funding of £2.1m. Mrs Robertson commented that PCIP funding was complex due to the way the funding had been allocated by the Scottish Government. She believed that tranche 2 of the funding was inaccurate as it amounted to zero and was probably a consequence of an error in the formulae used by Scottish Government. She confirmed that the PCIP figure would be what the actual allocation was.

5.10 Mr Nile Istephan echoed Dr Bhatti’s comments and suggested that the IJB had to do things differently in order to manage the budget and commission services moving forward. He suggested the delay in the national care service might free up some additional resource that could be redirected to the IJB.

5.11 Mr Chris Myers commented that it was a stark position and would have an impact on services and delivery and it was important that the IJB be mindful of that and express that to the public and local communities and some of that was already expressed in the strategic framework. The IJB was a legal entity and had statutory obligations and further work would be taken forward on financial governance with the help of the Director of Finance and Chief Financial Officer of NHS Borders and SBC respectively. He further commented that working closely with partner was important to ensure that where savings plans were agreed in one area they did not have a negative impact on another area.

5.12 In regard to the national care service he was unsure what the plans from the Scottish Government were given the current political turmoil. He advised that he would update the IJB on its request to be a pathfinder as soon as the Scottish Government advised him.

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