3 Minutes and Action Note
North Ayrshire Council · 25 August 2022
Back to Integration Joint Board — 25 August 2022 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 June 2022 at 10.00 a.m. involving participation by remote electronic means Present Voting Members Councillor Margaret Johnson, North Ayrshire Council (Vice Chair) Councillor Timothy Billings, North Ayrshire Council Councillor Anthea Dickson, North Ayrshire Council Marc Mazzucco, NHS Ayrshire and Arran Professional Advisers Caroline Cameron, Director of Health and Social Care Partnership Paul Doak, Head of Service (HSCP Finance and Transformation)/Section 95 Officer Iain Jamieson, Clinical Director Scott Hunter, Chief Social Work Officer Alistair Reid, Lead Allied Health Professional Adviser Darren Fullarton, Associate Nurse Director/IJB Lead Nurse Stakeholder Representatives Vicki Yuill, Third Sector Representative Glenda Hanna, Independent Sector Representative In Attendance Aileen Craig, IJB Monitoring Officer Alison Sutherland, Head of Service (Children, Families and Criminal Justice) Thelma Bowers, Head of Service (Mental Health) Michelle Sutherland, Partnership Facilitator, HSCP Eleanor Currie, Principal Manager – Finance Peter McArthur, Senior Manager (Addictions) Kerry Logan, Senior Manager (Health and Community Care) Kathryn Watt, Deloitte Lyndsey Wilson Hague, Phoenix Futures Scotland Rowanna McDonald, Phoenix Futures Scotland Elizabeth Crawford, Phoenix Futures Scotland Karen Andrews, Team Manager Angela Little, Committee Services Officer Craig Stewart, Committee Services Officer
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Apologies Bob Martin, NHS Ayrshire and Arran (Chair) Adrian Carragher, NHS Ayrshire and Arran Jean Ford, NHS Ayrshire and Arran Louise McPhater, North Ayrshire Council Louise McDaid, Staff Representative (North Ayrshire Council)/Chair, North Coast Locality Forum Pamela Jardine, Carers Representative 1. Apologies and Chair’s Remarks 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. Action Note The Board noted that the action plan was not included in the formal papers, it was noted that all actions are within agreed timescales and the reports on the three outstanding actions had been provided and would be discussed later on the agenda. 4. Appointments Submitted report by Caroline Cameron, Director (NAHSCP) on the appointment of members to various vacant positions on the IJB, Performance and Audit Committee and Strategic Planning Groups. The report detailed the appointments as follows:- • Councillors Margaret Johnson, Anthea Dickson, Timothy Billings and Louise McPhater as voting members of the IJB; • Councillor Margaret Johnson, as the North Ayrshire Council Cabinet Portfolio holder for Health and Social Care, as Vice-Chair of the IJB; • Councillor Timothy Billings will continue in his role as Chair of the Performance and Audit Committee; • three vacancies remain on the Performance and Audit Committee and IJB Members have been canvassed for nominations; • Councillor Margaret Johnson, as Vice-Chair of the IJB, is appointed as Chair of the Strategic Planning Group; • Pamela Jardine as the substantive Carer’s Representative on the IJB; • that the Depute Service User representative will continue in the role until a substantive replacement has been appointed; • Terri Collins as Staff Representative for the NHS; and • Dr. Iain Jamieson as Clinical Director for North Ayrshire HSCP. Noted.
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5. Child Poverty Report 2021/22 and Action Plan 2022/23 Submitted report by the Executive Director (Education and Communities) on the draft North Ayrshire Local Child Poverty Action Plan for 2022/23 and Report for 2021/22. The report and action plan were attached at Appendix 1 and summarised the ongoing and planned activity intended to reduce child poverty in North Ayrshire. Members asked questions and were provided with further information in relation to:- • The establishment of a Financial Inclusion project board to consider how to bring together the number of Council and HSCP teams providing financial inclusion services to make the services more effective and accessible to people in North Ayrshire; • Work that is underway to fill the Forum Chair vacancies and to ensure there is appropriate membership and representation on each Forum; • The 3-year strategy to tackle child poverty and the establishment of a new board in North Ayrshire to tackle child poverty, chaired by the Leader of the Council and supported by NHSAA, the North Ayrshire HSCP, the Third Sector Interface and Community Planning partners; and • work has been undertaken nationally and locally on teenage pregnancy including a full review of the school nursing pathway - all of which strengthen local approaches to supporting young parents The Board agreed (a) to approve the North Ayrshire Child Poverty Report 2021-22 and Action Plan 2022-23; (b) that the report be submitted to the Scottish Government and published on the North Ayrshire Community Planning Partnership website; (c) to approve the proposal to develop a strategy to tackle child poverty, covering the period 2023-26; (d) to approve the introduction of a “Tackling Child Poverty” Board to agree, monitor and deliver our local strategy in relation to the wide-ranging proposals within the Scottish Government’s Tackling Child Poverty Delivery Plan, to be chaired by the Council Leader; and (e) to grant permission to propose North Ayrshire as a “Pathfinder” local authority in tackling child poverty, as described in the Scottish Government delivery plan (Best Start, Bright Futures: tackling child poverty delivery plan 2022 to 2026). 6. Presentation: Phoenix Futures Development The Board received a presentation by Lyndsey Wilson Hague and James Armstrong on the work of Phoenix Futures Scotland to support those affected by drug and alcohol across the country in prison, community and residential settings. The presentation provided an update on progress with the acquisition of the Seabank Care Home building in Saltcoats which is being refurbished and opened as a National Family Rehabilitation Service. The presentation provided an update on the following areas:- • Residential rehabilitation model – a Scotland focus; • Need for the service, both nationally and locally; • National Specialist Family Service Model; • Childcare element of service provision; • Refurbishment progress; and • Good neighbour commitment and local support.
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Members asked questions and were provided with further information in relation to:- • An Engagement Plan that would ensure consultations and connections with the third sector, partners, Elected Members and the local community and Phoenix Futures approach to being accessible to any individuals or groups looking to find out more about the service; • The enhanced model of care and offering for residents of North Ayrshire and an assurance in terms of arrangements to ensure recovery is supported when individuals return home; • The recruitment of 30 staff with a wide range of knowledge and experience and work to recruit to the two remaining vacancies; • Examination of referral and follow up processes to ensure sustainable recovery for those returning home out with the local area; • Detailed meetings that have taken place with Primary Care Team to consider the impact on GP practices in the local area and a number of options that are being explored, noting local GPs do not have readily available capacity to support; • In-house clinical provision to triage any needs and requirements; • Further information that will be provided in relation to the provision enhanced package for island communities, noting that there will be one referral pathway and equitable access for all residents in North Ayrshire ; and • An invitation that was extended to the IJB to visit the facility. The IJB welcomed the update from Phoenix Futures and the offer for further engagement as the service develops. The update was noted. 7. Wider Scope Report: Audit Dimensions and Best Value Submitted report by External Auditors Deloitte on the ‘Audit Dimensions and Best Value’ for the year ended 31 March 2022. The scope of the audit work was risk based and proportionate, and covered the four audit dimensions of Financial Management, Financial Sustainability, Governance and Transparency and Value for Money. Responsibilities in relation to Best Value had been incorporated into the audit work. The purpose of the report and responsibility statement was also included, together with an Action Plan with recommendations for improvement. Members asked questions and were provided with further information in relation to:- • An initial induction session for Members that will take place following the summer recess and include a session on the Code of Conduct for Members; • An ongoing programme of training and development for Members that has been developed; and • Joint working across the three partnerships and NHS that will progress implementing delegated hospital budgets and set aside requirements. Noted. 8. Director’s Report Submitted report by Caroline Cameron, Director (NAHSCP) on developments within the North Ayrshire Health and Social Care Partnership. The report provided an update on the following areas:-
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• National developments that included the Children with Visual Impairment Event, the launch of the formal consultation on the Data Strategy for Health and Social Care and the Ministerial Statement on Accountability for Delivering the National Mission to Reduce Drug Deaths and Improve Lives; • the MARAC Launch across Ayrshire and Arran; • North Ayrshire Developments that included mPower/Digital Navigator Support, the new community support launch of ‘Our Community Space’ in three Garnock Valley towns, Co-creating Libraries, the Care at Home Inspection outcome, the Joint Inspection of Children’s Services and the phased re- opening of Older People’s Day Services; • Updates on Covid, Guidance, Managing Health and Social Care Staff with symptoms of a Respiratory Infection, or a positive Covid-19 test, Asymptomatic COVID-19 testing; Care Home settings and Vaccinations. Members asked questions and were provided with further information in relation to:- • National Infection Prevention and Control Guidance that is followed by Care Homes; • Further information on whether Care Home visitor testing is mandatory that will be forwarded to Members; • The recent Care Inspectorate Inspection of Care at Home and clarity that the scope of this did not include an inspection of Self Directed Support (SDS) and was focussed on direct care delivery through the in-house care at home service; • The commitment by the HSCP to support SDS through the establishment of an SDS Board so ensure legislation is applied and embedded appropriately across all services; and • The inclusion of pertinent updates in relation to the Covid pandemic within the Director’s report. The Board expressed its thanks and congratulations to staff within the Care at Home service for their tremendous achievement, following a Care Inspectorate inspection in May 2022 which assessed the service as Grade 5 (very good). Noted. 9. Financial Monitoring: 2021-22 Year End Performance Submitted report by Paul Doak, Head of Service (HSCP Finance and Transformation) on the IJB’s year-end financial performance and the implications for the IJB’s overall financial position, including an update on the financial impact of the Covid-19 response. Appendix A to the report provided the financial overview of the partnership position, with the position in relation to earmarked funds carried forward for use in 2022/23 detailed in Appendix B. The final BRAG status around the deliverability of each saving was provided at Appendix C. Appendix D highlighted the movement in the overall budget position for the Partnership following the initial approved budget and the local finance mobilisation plan submission was detailed at Appendix E to the report.
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Members asked questions and were provided with further information in relation to:- • Underspends in Mental Health, largely as a result of challenges around recruitment and the approaches the service are taking to grow the workforce; • The establishment of a Workforce Planning Group to consider the best skills mix approach and the challenges in recruiting to some of the most difficult professional roles; • The development of a National Workforce Strategy in relation to these challenges for Mental Health Services; • Additional workforce planning resources consider recruitment from a national perspective and collaborative recruitment processes across Scotland; and • Work with NSD on the delivery of Foxgrove, the completion of a Needs Assessment and commencement of recruitment. The Board agreed to (a) note the overall integrated financial performance for the financial year 2021-22 and the overall year-end underspend of £21.148m, adjusted to £2.916m after earmarking; (b) note the updated costs of the Covid response and the funding received; (c) note that out-with the IJB overall position, the £1.486m debt repayment has been made to North Ayrshire Council as planned; (d) approve the budget changes outlined at section 2.11 of the report; and (e) approve the proposed earmarking of £18.232m of reserves as detailed in the report, leaving a balance of £2.916m in free general fund reserves. 10. Risk Management Strategy Submitted report by Paul Doak, Head of Service (HSCP Finance and Transformation) on an updated Partnership Risk Management Strategy, detailed at Appendix 1 to the report. The Board agreed to approve the Risk Management Strategy detailed at Appendix 1 to the report. 11. Community Alarm/Telecare Service transition from Analogue to Digital (IP) Submitted report by Kerry Logan, Senior Manager on the Community Alarm/Telecare Services transition from Analogue to Digital Service Internet Protocol (IP) and on how HSCP would support service users. Members asked questions and were provided with further information in relation to:- • Recruitment that is underway for a new Project Planning Team; and • Digital infrastructure in rural areas that would be examined by the Project Planning Team transition to ensure accessibility for service users on an individual basis. Noted.
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12. Distress Brief Intervention Update Submitted report by Thelma Bowers, Head of Service on the progress of implementation of the Distress Brief Intervention (DBI) Service. Appendix 1 to the report provided an infographic update on the progress of the national programme. Members asked questions and were provided with further information in relation to:- • The Implementation Plan that would build capacity in primary care to support primary care colleagues to undertake DBI Level 1 training; • Data on fluctuations in referral rates including over holiday periods would be examined by the Steering Group as well as the demographics of the information captured. The Board agreed to endorse the implementation of the plan to support DBI across Ayrshire. Aileen Craig, IJB Monitoring Officer left the meeting at this point. 13. Support for Unpaid Carers in North Ayrshire Submitted report by Scott Hunter, Chief Social Work Officer providing an update on developments to improve support to unpaid carers in North Ayrshire, including a programme plan and timeline for proposed changes. The current North Ayrshire Carer’s Eligibility Criteria was attached at Appendix 1 to the report. The Board agreed to (a) approve (i) the approach described in the report to provide improved support for unpaid carers in North Ayrshire; and (ii) the amended Carer’s eligibility criteria threshold to support individuals with low and moderate need levels, instead of just substantial and critical levels of need; and (b) note the content of the report. 14. Whistleblowing Report – Quarter 4, January to 31 March 2022 Submit report by Karen Callaghan, Corporate Governance Co-ordinator in relation to whistleblowing concerns raised in Quarter 4 (January-31 March 2022). Noted. 15. Urgent Item The Chair agreed to consider the following matter as a matter of urgency, to allow the Board to be provided with an update without delay. 15.1 Unscheduled Care Performance Submitted report by Caroline Cameron, Director (NAHSCP) outlining the responsibilities of the IJB in commissioning and oversight of performance in relation to Unscheduled Hospital Care in relation to the Acute Set Aside resource. The report highlighted areas of concern in relation to performance and to recommend the IJB seek regular updates on the programme of work to improve patient experience and outcomes. Members asked questions and were providing with further information in relation to:-
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• The Flow Navigation Centre that works towards the prevention of attendance at A&E and admission to hospital; • The range of work that is underway around discharge without delay to reduce the impact on the individuals being delayed within a hospital environment for longer than required; • Discussions at the next meeting of the IJB PAC on ongoing reporting of performance information in relation to unscheduled care on a wider Ayrshire and Arran context and whether this should be embedded within future performance reports. The Board agreed to (a) note the ongoing programme of work in relation to Unscheduled Care and specifically the improvements required in length of stay for patients and performance in relation to the 4 hour ED compliance standard; (b) receive a performance update at the next meeting in August and thereafter consider any further interventions required; and (c) note that any additional resource required to facilitate performance improvement activity should be through a spend to save methodology by closing all 138 additional acute hospital beds during 2022-23. The meeting ended at 12.38 p.m.
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North Ayrshire Integration Joint Board – Action Note Updated following the meeting on 16 June 2022 No. Agenda Item Date of Meeting Action Status Officer 1. Mental Welfare Commission Report: Authority to Discharge 21/10/21 The Board agreed to (a) note the terms of the report; (b) approve the North Ayrshire Health and Social Care Partnership response to the recommendations; and (c) receive an update report to the IJB in 12 months in terms of progress with the recommendations of the Mental Welfare Commission report. Update by October 2022 David Thomson 2. Risk Appetite Statement 14/2/22 The Board agreed to (a) request the IJB PAC to consider the feedback from the IJB in respect of the risk appetite statement; and (b) approve the Partnership Risk Appetite Statement. Considered at PAC with recommendation that impacts section of report template incorporates alignment with risk appetite, will be embedded in reports where decision required. Action closed Paul Doak 3. Communities Mental Health & Wellbeing und 17/3/22 The Board agreed to (a) note the terms of the report; and (b) note that a report would be brought to a future meeting of the Board, for consideration, which would provide learning and an evaluation of what worked, and what did not, in respect of the Fund distribution process, etc. Update to a future Board (date: tbc) Vicki Yuill 4. Medium-Term Financial Outlook 17/3/22 The Board agreed to (a) note the Medium- Term Financial Outlook and the potential financial position in years 2 and 3; and (b) approve the setting up of a Workshop, at the appropriate time, in order to help and Planned IJB workshop to incorporate this in September 2022 Paul Doak
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facilitate consideration of matters going forward once the funding position, by the Scottish Government, had become clearer. 5. Unscheduled Care Performance 16/6/22 The Board agreed to (a) (b) receive a performance update at the next meeting in August and thereafter consider any further interventions required; and (c) Further update report to be presented to IJB in September Caroline Cameron