3 - 220825 - IJB Minute
North Ayrshire Council · 22 September 2022
Back to Integration Joint Board — 22 September 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 25 August 2022 at 10.00 a.m. involving participation by remote electronic means and physical attendance within the Council Chambers, Irvine. Present (Physical Participation) Voting Members Bob Martin, NHS Ayrshire and Arran (Chair) Councillor Margaret Johnson, North Ayrshire Council (Vice Chair) Councillor Anthea Dickson, North Ayrshire Council Louise McPhater, 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 Darren Fullarton, Associate Nurse Director/IJB Lead Nurse 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 Adrian Carragher, NHS Ayrshire and Arran Christie Fisher, NHS Ayrshire and Arran Marc Mazzucco, NHS Ayrshire and Arran Professional Advisers Alistair Reid, Lead Allied Health Professional Adviser Stakeholder Representatives Pamela Jardine, Carers Representative Vicki Yuill, Third Sector Representative In Attendance (Physical Participation) Alison Sutherland, Head of Service (Children, Families and Criminal Justice) Thelma Bowers, Head of Service (Mental Health) David Thomson, Head of Service (Health and Community Care) Stuart McKenzie, Senior Manager, CAMHS Karen Andrews, Team Manager Diane McCaw, Committee Services Officer Hayley Clancy, Committee Services Officer
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In Attendance (Remote Participation) Michelle Sutherland, Partnership Facilitator, HSCP Eleanor Currie, Principal Manager – Finance Peter McArthur, Senior Manager (Addictions) Scott Bryan, Strategic Planning Policy and Inequalities Officer Pat Kenny, Deloitte Ellis Davidson Horne, Deloitte Apologies Dr. Louise Wilson, GP Representative Philip Hodkinson, Acute Services Representative Janet Davies, Lead Psychologist Aileen Craig, IJB Monitoring Officer 1. Apologies and Chair’s Remarks Apologies for absence were noted. The Chair welcomed Christie Fisher as the new NHS Non-Executive Member of the Integration Joint Board and thanked Jean Ford and Philip Hodkinson for their valuable contributions to the work of the IJB. The Chair agreed to vary the order of business to allow consideration of Agenda Item 16: Appointments as the first item to provide an update on current Membership to the Board. 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. Appointments Submitted report by Caroline Cameron, Director (NAHSCP) which detailed the appointment of Christie Fisher as the new NHS Non-Executive Member of the North Ayrshire Integration Joint Board. The Board agreed to (a) note the appointment of Christie Fisher as the new NHS Non- Executive Member; and (b) approve the appointment of Christie Fisher to the Performance and Audit Committee. 4. Minutes/Action Note The accuracy of the Minutes of the meeting held on 16 June 2022 were confirmed and the Minutes signed in accordance with Paragraph 7 (1) of Schedule 7 of the Local Government (Scotland) Act 1973. 4.1 Matters Arising from the Action Note Updates in terms of the Action Note were detailed as follows:-
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• Mental Welfare Commission – report to be brought back to the IJB by October 2022; • Risk Appetite Statement - recommendation from PAC that report template be amended to incorporate alignment with Risk Appetite and this will be embedded in future reports to IJB where a decision is required; • Communities Mental Health and Wellbeing – update to be provided to a future IJB; • Medium-term Financial Outlook – discussion on sharing more information will be incorporated into the IJB Development Workshop in September; and • Unscheduled Care Performance – verbal update at Agenda Item 14. Noted. 5. 2021/22 Audited Annual Accounts Submitted report by Paul Doak, Head of Service (HSCP Finance and Transformation) on the Audited Accounts for 2021-22, attached at Appendix 1 to the report. Appendix 2 included the letter of representation signed by the Chief Finance Officer (NAHSCP). The IJB’s accounts for the year to 31 March 2022 were submitted to Deloitte LPP in accordance with the agreed timetable. Deloitte have given an unqualified opinion that the 2021/22 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. During the audit, minor amendments were required around the presentation of the prior year adjustment in respect of the £500 Covid ‘thank you’ payments which were reported to the IJB through the financial monitoring reports in 2021-22 and in the remuneration report. The overall financial position remains as reported to the Performance and Audit Committee in June 2022. The Board agreed to (a) note that Deloitte LLP have completed their audit of the annual accounts for 2021-22 and have issued an unqualified independent report auditor’s report; (b) approve the Audited Annual Accounts to be signed for issue. 6. External Audit Final Report Submitted report by Deloitte on the External Audit Final Report on the Audit of Financial Statements. The key messages of the report were:- • it was expected that an unmodified audit opinion would be issued; • effective budget settings and monitoring arrangements were in place supported by an experienced finance team and robust internal audit function; • a balanced budget had been set for 2022/23, holding unearmarked reserves at a level consistent with its Reserves Strategy and therefore financially sustainable in the short term; • the IJB continued to have strong leadership with more tailored training being developed for Board Members; and
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• there continued to be a clear and robust performance management framework and sufficient arrangements in place to secure best value and in terms of areas requiring further development. The Chair thanked Deloitte for their work over the years in auditing the IJB and for the valued working relationship. Noted. 7. 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:- • National developments that included the National Suicide Statistics, the State of Caring 2022 Survey, the consultation on Mental Health and Wellbeing Strategy and the Call for Views and Your Priorities digital consultation on the National Care Service (Scotland) Bill; • A future report to be provided to the IJB on suicides, drug and alcohol related deaths; • Ayrshire wide developments that included Awards from the NHS Scotland Event and an update on MARAC Go Live on 1 August 2022; • North Ayrshire Developments that included Welfare rights Officers in Schools, the launch of a new Wellbeing Instagram Account, the continued partnership with the National Portrait Gallery and the new support resource for staff affected by the death of a young person by suicide; and • An update on the Covid vaccination programme alongside the flu vaccination programme. Louise McPhater left the meeting at this point. Members asked questions and were provided with further information in relation to:- • The vaccination programme being delivered by start of December 2022; and • Whether the vaccination programme would also include those who work privately as carers. Noted. 8. 2022-23 Month 3 Financial Performance Submitted report by Paul Doak, Head of Service (HSCP Finance and Transformation) on the financial position of the Health and Social Care Partnership. Appendix A to the report provided the financial overview of the partnership position, with the full Transformation Plan for 2022/23 provided in Appendix B. Appendix C provided an overview of those service changes with financial savings attached to them
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and the current BRAG status around the deliverability of each saving. Appendix D outlined the movement in the overall budget position for the Partnership following the initial approved budget. The local finance mobilisation plan submission was provided at Appendix E to the report with Appendix F showing the IJB reserves position in detail. Members asked questions and were provided with further information in relation to:- • the timing of budget revisions in terms of readjustments; • planning for the future in relation to complex care and delayed discharges; • the carers underspend figure presented in June being the final position for the last financial year; and • the projected carers underspend figure for this financial year being lower than last year. The Board agreed to (a) note the overall integrated financial performance report for the financial year 2022-23 and the current overall projected year-end overspend of £0.050m; (b) note the progress with delivery of agreed savings; (c) note the remaining financial risks for 2022-23, including the impact of remaining Covid-19 estimates and costs; and (d) approve the budget reductions detailed at Paragraph 2.11 of the report. 9. Ayrshire and Arran CAMHS Reform Programme Submitted report by Stuart McKenzie, Senior Manager on the CAMHS Reform Programme and the actions progressed to continue to implement a programme of significant reform. Appendix 1 detailed hyperlinks in relation to strategic documents mentioned within the report. The report also highlighted areas of redesign and response associated with the Recovery and Renewal plans which evolved through and beyond the Covid-19 Pandemic. Members asked questions and were provided with further information in relation to:- • challenges regarding recruitment and any associated delays with commencement of projects; • opportunities to evolve nursing practice in terms of child and young person mental health; • work within communities to understand the needs of neurodivergent individuals; • development of the language and narrative across all aspects of mental health; and • the commissioning of an ‘Extreme Team’ approach across Ayrshire and Arran enabling targeted resource allocation to ensure early intervention in relation to children and young people. Noted. 10. The Promise in North Ayrshire: Update on Progress Submitted report by Alison Sutherland, Head of Service (Children, Families and Criminal Justice) in relation to ongoing work within North Ayrshire to deliver The
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Promise to our children and young people. Appendix 1 to the report detailed The Promise Governance Chart. The report outlined progress being made nationally and locally and detailed the key next steps until March 2024. Members asked questions and were provided with further information in relation to:- • the levels and trends in relation to children in care; • the alignment of further services to early intervention and prevention approaches; • the commitment from the Scottish Government in terms of funding and the allocation to the Family Wellbeing Fund; • discussions with Children’s Services Planning Group partners on the management of progress; and • engagement with the third sector. The Board agreed to note (a) the progress in North Ayrshire to lay the foundations to deliver on the ambitions of The Promise and on the further areas of work planned during Phase 1 to 2024; and (b) that a further progress report and action plan will be remitted to IJB following The Promise Conference to be held in November 2022. 11. Joint Inspection of Children’s Services Submitted report by Alison Sutherland, Head of Service (Children, Families and Criminal Justice) on the findings of the Joint Inspection of Services for Children and Young People at risk of harm. The full report by the Care Inspectorate, noting key findings, strengths and good practice, was detailed at Appendix 1 to the report. The Board agreed to note the contents of the report including (i) the publication of the Joint Inspection of Services for Children and Young People at risk of harm in North Ayrshire Community Planning Partnership area in June 2022; (ii) the very positive nature of the report, key findings, strengths and good practice and how it reflects the commitment and dedication of staff working across agencies; and (iii) the identified areas for further improvement. 12. North Ayrshire HSCP and ADP Annual Performance Management Report – Alcohol and Drugs Submitted report by Peter McArthur, Senior Manager, Addiction detailing annual performance information in relation to alcohol and drugs. The Annual Performance Report was attached at Appendix 1 to the report and provided details of access to treatment waiting times, alcohol brief interventions, Naxolone supply, drug related deaths, training delivery and finance. Members asked questions and were provided with further information in relation to:- • financial information on funding streams and the challenge for the Partnership and community groups to deliver supportive interventions; • individuals with lived experience providing support to others while balancing their own recovery; • the concern regarding gambling in relation to mental health and wellbeing; • the number of reported lives saved through the use of Naloxone across North Ayrshire; • Naloxone kit expiry dates and publicity around replacement kits; and
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• a future report from the ADP giving a clearer understanding in terms of drug types which have contributed to drug death statistics. Noted. 13. North Ayrshire HSCP and ADP Implementing Medication Assisted Treatment (MAT) – Annual Report Submitted report by Peter McArthur, Senior Manager, Addiction, on the implementation of the new Medication Assisted Treatment (MAT) Standards. The MAT Annual Summary report was detailed in Appendix 1 to the report while Appendix 2 provided detail of the RAG status for each of the MAT Standards 1-5 for each of the ADP areas. Appendix 3 detailed an overview of the MAT Implementation Support Team’s (MIST’s) assessment of MAT implementation in North Ayrshire including a number of Improvement Actions and Appendix 4 noted to obligations contained within recent correspondence from the Minister for Drugs Policy. Members were provided with further information in relation to the new governance arrangements in terms of accountability for Chief Officers and Chief Executives. Noted. 14. Unscheduled Care Update The Board received a verbal update by Caroline Cameron, Director (NAHSCP) following the report to the last meeting of the IJB on 16 June 2022. The verbal update included information in relation to:- • ongoing work in terms of rightsizing the bed footprint in acute hospitals; • no additional bed closures to date; • a number of focussed ‘discharge without delay’ events supported by HSCP colleagues across Ayrshire and Arran; • clear targets in place in relation to future phased additional bed closures prior to the winter period; and • a key priority for improvements in terms of safe staffing levels and patient care experience. The Board was also informed of a Pan-Ayrshire agreement to report back to IJBs in September an update in terms of any impact on performance, the position in relation to hospital beds, the learning from ‘Discharge Without Delay’ events and an outline of the next steps. Noted. 15. NAHSCP Draft Workforce Plan 2022-25 Submitted report by Scott Bryan, Interim Programme Manager, Strategic Planning on the draft Workforce Plan 2022-25. The draft Workforce Plan was detailed in full at Appendix 1 to the report. Appendix 2 provided information on actions and desired outcomes.
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Members asked questions and were provided with further information in relation to:- • nursing gaps highlighted within the Plan; • consultation and engagement with professional leads from a range of stakeholders; • collective discussion in terms of future workforce; and • the inclusion within the Plan of a further commitment to work with the Third Sector to identify and deliver plans and resources. The Board was advised to contact Scott Bryan direct with any further feedback in relation to the Plan. Noted. 16. Clinical and Care Governance Annual Report Adrian Carragher left the meeting at this point. Submitted report by Darren Fullarton, Lead Nurse/Associate Nurse Director providing Clinical and Care Governance Group (CCGG) update on governance activity for the period August 2021 – August 2022. The revised Terms of Reference for the CCGG were detailed at Appendix 1 to the report. Appendix 2 detailed action plans in response to recommendations from the Mental Welfare Commission visits across North Ayrshire. Members asked questions and were provided with further information in relation to:- • a potential refresh of the staff input to the Group; and • specific input from the pharmacy professional group. Noted. The meeting ended at 12.40 p.m.
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North Ayrshire Integration Joint Board – Action Note Updated following the meeting on 25 August 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. Communities Mental Health & Wellbeing Fund 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 has been included in the MH Recovery and Renewal Report tabled on 22/9/22 – no further action required. Vicki Yuill 3. 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 facilitate consideration of matters going forward once the funding position, by the Scottish Government, had become clearer. Agreed to Set up a Workshop, at the appropriate time, once funding position, by the SG, had become clearer. Update – IJB Development Workshop taking place in September 2022. Paul Doak
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4. 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) Verbal update provided 25 August 2022. This will be deferred to IJB on 20 October to align with East and South Ayrshire Caroline Cameron 5. Director’s Report 25/8/22 A future report to be provided to the IJB on suicides, drug and alcohol related deaths. Date tbc Caroline Cameron 6. The Promise in North Ayrshire: Update on Progress 25/8/22 The Board agreed to note (b) that a further progress report and action plan will be remitted to IJB following The Promise Conference to be held in November 2022. Early 2023 Alison Sutherland 7. North Ayrshire HSCP and ADP Annual Performance Management Report – Alcohol and Drugs 25/8/22 A future report to IJB from the ADP giving a clearer understanding in terms of drug types which have contributed to drug death statistics. IJB 17 November 2022 Billy Brotherston/ Peter McArthur