231116 Minute & Action Note
North Ayrshire Council · 14 December 2023
Back to Integration Joint Board — 14 December 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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North Ayrshire Health and Social Care Partnership Minute of Integration Joint Board meeting held on Thursday 16 November 2023 at 11.00 a.m. involving participation by remote electronic means and physical attendance within the Council Chambers, Irvine. Present (Physical Participation) Voting Members Councillor Margaret Johnson, North Ayrshire Council (Chair) Joyce White, NHS Ayrshire and Arran (Vice-Chair) Councillor Anthea Dickson, North Ayrshire Council Professional Advisers Caroline Cameron, Director of Health and Social Care Partnership Paul Doak, Head of Service (HSCP Finance and Transformation)/Section 95 Officer Scott Hunter, Chief Social Work Officer Sharon Hackney, Lead Allied Health Professional Leigh Whitnall, Head of Psychological Specialties Stakeholder Representatives Louise McDaid, Staff Representative (North Ayrshire Council)/Chair, North Coast Locality Forum Present (Remote Participation) Voting Members Councillor Timothy Billings, North Ayrshire Council Christie Fisher, NHS Ayrshire and Arran Professional Advisers Elaine Young, Public Health Representative Stakeholder Representatives Pamela Jardine, Carers Representative Vicki Yuill, Third Sector Representative In Attendance (Physical Participation) Eleanor Currie, Manager, HSCP Kerry Logan, Head of Service (Health and Community Care) Michelle Sutherland, Partnership Facilitator, HSCP Betty Saunders, Senior Manager (Contracts and Commissioning) Julie Barrett, NHS Ayrshire and Arran David Jamieson, Audit Scotland Fiona Mitchell-Knight, Audit Scotland Diane McCaw, Committee Services Officer Hayley Clancy, Committee Services Officer
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Apologies Marc Mazzucco, NHS Ayrshire and Arran Elizabeth Stewart, Head of Service (Children, Families and Criminal Justice) Thelma Bowers, Mental Health Adviser 1. Apologies for Absence Apologies for absence were noted. 2. Declarations of Interest There were no declarations of interest in terms of Standing Order 7.2 and Section 5.14 of the Code of Conduct for Members of Devolved Public Bodies. 3. Minutes The accuracy of the Minutes of the meeting held on 12 October 2023 were confirmed and the Minutes signed in accordance with Paragraph 7(10 of Schedule 7 of the Local Government (Scotland) Act 1973. 3.1 Matters Arising from the Action Note Updates in terms of the Action Note were detailed as follows: - • Implementation of the National CAMHS and Neurodevelopmental Specifications – Formal report to be presented to IJB in December 2023. • Director’s Report: Commissioned Services - on the agenda for the meeting. • Director’s Report: Community Mental Health Fund – Update on year 1 and year 2 fund to be presented to a future meeting. • Director’s Report: Audit Scotland report - Update scheduled for February 2024. • Chief Social Work Officer Annual Report: Justice Services Update – Update to be brought early 2024. 4. Director’s Report Submitted report by Caroline Cameron, Director (NAHSCP) on the developments within the North Ayrshire Health and Social Care Partnership. The report provided an update on the following areas: - • Health and Care (Staffing) (Scotland) Act 2019 comes into force on 1 April 2024; • The Scottish Government published Good Practice Guidance on Delayed Discharges that aims to provide HSCPs models of good practice to support a reduction in delayed discharges where adults lack capacity; • Section 23 of the Mental Health (Care and Treatment) (Scotland) Act 2003 places a duty on Health Boards to provide sufficient services and accommodation for all young people up to the age of 18 years who require hospital admission for the treatment of mental disorder. As part of its monitoring duties the Commission routinely gathers information about the admission of young people to non-specialist wards (usually adult mental health wards) and reports on these admissions on an annual basis. The latest annual report
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published was on 2 November 2023 and can be accessed via this link https://www.mwcscot.org.uk/node/2096; • The Mental Health and Wellbeing Delivery Plan 2023-2025 and the Mental health Welling Workforce Action Plan 2023 – 2025 recently published by the Scottish Government; • A new Waiting Well Hub launched on NHS Inform, to support people who may be waiting to see a healthcare specialist or to get health and social care services. The Hub aims to provide access to better information to support people to proactively manage their health and wellbeing, to think about what matters to them and what health improvements they could make during this time; • The Health and Social Care Winter Preparedness Plan for 2023/24, was published on 24 October 2023 - https://www.gov.scot/isbn/9781835214343; • On 25 October 2023, the First Minister announced that young people transitioning from the care system into adulthood are to receive a one-off Care Leaver Payment of £2,000 to support them to move into adulthood and more independent living with a public consultation on the Care Leaver Payment launched and will run until 26 January 2024; • Carolyn McDonald, Chief AHP Officer with the Scottish Government visited Ayrshire on Monday 30 October 2023. The visit provided a useful opportunity to showcase the positive AHP contribution to the people of Ayrshire; • The IJB were advised of the Care Inspectorate issuing North Ayrshire HSCP formal notification of a joint inspection of Adult Support and Protection across agencies including Social Work, Health, and Police. The partnership position statement was submitted on 8 November. The first stage of the inspection will commence on 27 November 2023 with the casefile reading and will be followed up with focus groups; • North Ayrshire Libraries were winners at the Scottish Library & Information Council (SLIC) Awards on 3rd November for their pioneering work in supporting those recovering from problematic alcohol and/or other drug use; • The Dirrans Centre had two finalists in the Working North Ayrshire Awards on 2nd November 2023. Michael was a finalist in the Volunteer of the Year Category and Abby Anderson was voted Modern Apprentice of the Year; • Tracey McAllister, Charge Nurse was the recipient this month of The Bill Gray Award for excellence in dementia care. The photo is of her, the team and Annabelle Gray who set up the award a few years ago in recognition of the excellent care her husband Bill received in Iona /Lewis Ward at Ailsa Hospital; • Students of RAMH North Ayrshire Wellbeing & Recovery College have released a single as part of the Scottish Mental Health Arts Festival, which took place during October; • the appointment of Dr Wendy Van Riet to the Director of Psychological Services for NHS Ayrshire & Arran based within North Ayrshire HSCP as the Lead HSCP for Mental Health Services; and • Elizabeth Stewart has been appointed the Head of Service (Children, Families & Justice). Noted. 5. Contract and Commissioning Update Submitted report and received presentation by Betty Saunders, Senior Manager (Contracts and Commissioning) on the current Contracts and Commissioning
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landscape. The types of care and support services commissioned was set out at Appendix 1 to the report. The presentation highlighted the North Ayrshire Care and Support market profile, 2022-2023 financial year spend, current purchase routes, monitoring the quality of care, managing care deficiencies, existing supports for providers, challenges and opportunities, snapshot of mid-October, priorities for 2024, Members asked questions and were provided with further information in relation to: - • distress brief intervention figures; • difficulties in commissioning residential step down care and next steps to move this forward; • current supports in place for external providers who may fall below the minimum performance grade. Noted. 6. 2023 – 2024 Month 6 Financial Performance Submitted report by Paul Doak, Head of Service (HSCP Finance and Transformation), on the IJB’s financial performance as at month 6 (September). Appendix A to the report detailed the Objective Summary as at 30 June 2023, Appendix B provided the financial savings tracker and the budget position was set out at Appendix C. Members asked questions and were provided with further information in relation to: - • the current reserves position following the reserves adjustment detailed in the Audit Scotland report; • additional processes in place to understand the reason for the reserves adjustment and minimise the risk in the future; and • the local government pay award settled for the majority of staff, with the back pay being paid before Christmas. The Board agreed to (a) note (i) the overall integrated financial performance report for the financial year 2023-24 and the current overall projected yearend overspend of £3.986m, (ii) the progress with delivery of agreed savings and (iii) the remaining financial risks for 2023-24; and (b) approve the budget reductions set out at section 2.10 of the report. 7. External Audit Final Report Submitted report by Audit Scotland on the External Audit Final Report of the audit Financial Statements. The key messages of the report were: - • it was expected that an unmodified audit opinion would be issued; • appropriate and effective financial management arrangements were in place; • the IJB reported a £3.7 million underspend against the 2022/23 budget. The main factor for the underspend was the continued workforce challenges to recruit and maintain staff in the social care sector;
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• the updated medium-term financial outlook shows a cumulative estimated savings gap ranging from best case £1.1 million to worst case £22.7 million in the period to 2026/27; • work currently ongoing to refresh the Transformation Plan to focus on the financial challenges ahead; • The IJB has a clear strategic vision supported by its partners; • A review of the Integration Scheme currently ongoing. A revised scheme will be considered by the end of 2023/24 and submitted to the Scottish Government for approval; • Governance arrangements were appropriate and generally operate effectively; • Performance management arrangements were effective with indicators and targets kept under review. These arrangements contribute to the IJB’s Best Value duty; • Performance in relation to the national measures highlights both areas of improvement and areas of declining performance over the last year. The Partnership noted that a report on the reserves adjustment detailed in the Audit Scotland report would be brought to a future meeting. Members asked a question and received clarification on an outstanding action from 2022/2023. The Chair thanked Audit Scotland for their work in auditing the IJB. Noted. 8. 2022/2023 Audited Annual Accounts Submitted report by Paul Doak, Head of Service (HSCP Finance and Transformation) on the Audited Accounts for 2022-23, attached at Appendix 1 to the report. Appendix 2 included the letter of representation signed by the Head of Service (HSCP Finance and Transformation). The IJB was required to produce a set of annual accounts for 2022-23. These accounts were produced within the statutory timescale and subject to independent audit by the Integration Joint Board’s external auditors, Audit Scotland. Audit Scotland have given an unqualified opinion that the 2022-23 financial statements give a true and fair view of the financial position and expenditure and income of the IJB for the year, concluding that the accounts have been properly prepared in accordance with relevant legislation, applicable accounting standards and other reporting requirements. The overall financial position remains as reported to the Performance and Audit Committee in June 2023. Audit Scotland identified an accounting misstatement during the audit relating to a difference between total IJB reserves (£17.664million) and the debtor balances due to the IJB from partners’ audited accounts (£16.728million). This is well within the materiality threshold. This difference requires to be reviewed through the ledgers and any corrective action will be taken ahead of the 2023-24 audit and reported to the IJB. The Board agreed to (a) note that Audit Scotland have completed their audit of the annual accounts for 2022-23 and have issued an unqualified independent report auditor’s report; (b) approve the Audited Annual Accounts to be signed for issue. 9. Risk Appetite Statement
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Submitted report by Paul Doak, Head of Service (HSCP Finance and Transformation) on the Risk Appetite Statement, with the Statement set out at Appendix 1 to the report. Members asked questions and were provided with further information in relation to: - • cultural changes required to have a more flexible innovative workforce and attract a younger workforce; and • retaining the workforce with policies such as retire and return, partial retirement, VER in place. The Board agreed to approve the Risk Appetite Statement set out at Appendix 1 to the report. 10. Independent Advocacy Strategic Plan 2022-2026 Submitted report by Julie Barrett (NHS Ayrshire and Arran) on the Advocacy Strategic Plan, with the Plan set out at Appendix 1 to the report. The Board agreed to approve the Advocacy Strategic Plan set out at Appendix 1 to the report. The meeting ended at 12.35 p.m.
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North Ayrshire Integration Joint Board – Action Note Updated following the meeting on 16 November 2023 No. Agenda Item Date of Meeting Action Status Officer 1. Implementation of the National CAMHS and Neurodevelopmental Specifications 16/3/23 Further update being provided to the IJB, potentially prior to the summer recess period. On agenda December 2023. Thelma Bowers 3. Director’s Report 12/10/23 Community Mental Health Funding - The Impact Report for Year 1 and Interim Report for Year 2 to a future meeting. tbc Vicky Yuill 4. Director’s Report 12/10/23 Audit Scotland report for the Auditor General of Scotland and the Accounts Commission on Access to Mental Health Services - a report would be brought to a future meeting to consider the recommendations Update scheduled for February 2024. Thelma Bowers 5. Chief Social Work Officer Annual Report 2022/2023 12/10/23 Justice Services update report to be brought to a future meeting. Update to be brought early 2024. Elizabeth Stewart 6. External Audit Final Report 16/11/23 An update on the reserves adjustment detailed in the Audit Scotland report would be brought to a future meeting. Incorporated into the financial monitoring report presented to IJB December 2023. Paul Doak