3. 221020 Minute and Action Note
North Ayrshire Council · 17 November 2022
Back to Integration Joint Board — 17 November 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 20 October 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) Professional Advisers Caroline Cameron, Director of Health and Social Care Partnership Scott Hunter, Chief Social Work Officer Alistair Reid, Lead Allied Health Professional Adviser Stakeholder Representatives Pamela Jardine, Carers Representative Present (Remote Participation) Voting Members Councillor Timothy Billings, North Ayrshire Council Marc Mazzucco, NHS Ayrshire and Arran Stakeholder Representatives Louise McDaid, Staff Representative (North Ayrshire Council)/Chair, North Coast Locality Forum Vicki Yuill, Third Sector Representative In Attendance (Physical Participation) Elaine Young, Head of Health Improvement/Assistant Director of Public Health (NHS) Thelma Bowers, Head of Service (Mental Health), HSCP David Allan, Senior Manager (Health and Community Care), HSCP Michelle Sutherland, Partnership Facilitator, HSCP Scott Bryan, Strategic Planning, Policy and Inequalities Officer, HSCP Ruth Wilson, Team Manager (Democratic Services) Karen Andrews, Team Manager Hayley Clancy, Committee Services Officer Diane McCaw, Committee Services Officer In Attendance (Remote Participation) Roseanne Burns, Senior Manager (Children, Families and Justice) Apologies Christie Fisher, NHS Ayrshire and Arran
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Councillor Anthea Dickson, North Ayrshire Council Paul Doak, Head of Service (HSCP Finance and Transformation)/Section 95 Officer Alison Sutherland, Head of Service (Children, Families and Criminal Justice) David Thomson, Head of Service (Health and Community Care) 1. Apologies for Absence and Chair’s remarks Apologies for absence were noted. The Chair welcomed David Allan and Roseanne Burns, Senior Managers (Health and Community Care), together with Elaine Young, Assistant Director of Public Health, to their first meetings of the IJB. He further thanked Alastair Reid for his invaluable input to the Partnership and wished him luck with his secondment to Health Improvement Scotland for a 2-year period. 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/Action Note The accuracy of the Minutes of the meeting held on 22 September 2022 were confirmed and the Minutes signed in accordance with Paragraph 7 (1) 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:- • Mental Welfare Commission Report – Authority to Discharge – to be considered at Agenda Item 7. Marked as complete. • Communities Mental Health and Wellbeing fund – Update in terms of Community Mental Health and Wellbeing Fund networking event. An invitation has been circulated and promoted and anyone with intentions to attend event advise Vicki Yuill as event is well subscribed currently. Marked as complete. • Medium-term Financial Outlook – Development Workshop took place on 22 September 2022 and a follow-up workshop will be arranged to give IJB an update on budget for next financial year. Marked as complete. • Unscheduled Care Performance – Verbal Update at Agenda Item 8. Report to be provided to meeting on 17 November 2022. • Directors Report: Suicides, Drug and Alcohol Related Deaths – report to be provided to a future meeting – date to be confirmed. • The Promise in North Ayrshire Update on Progress – further report and action plan to a future meeting – date to be confirmed. • North Ayrshire HSCP and ADP Annual Performance Management Report – Alcohol and Drugs – report to be incorporated into Suicides, Drug and Alcohol Related Deaths report. • Recovery and Renewal for Mental Health – this will be incorporated into development programme for IJB and a Seminar arranged. Noted. 4. Director’s Report
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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 launch of the Creating Hope Together: Scotland’s New Suicide Prevention Strategy and that IJB to receive updates on local approach to implementation, the launch of the ‘National Conversation’ for the New Dementia Strategy, the first National Care Service Forum held on 3 October 2022, the Independent Review of Inspection, Scrutiny and Regulation of Social Care in Scotland, the findings of the inquiry into health inequalities in Scotland and the Winter Resilience Overview 2022-2023; • Ayrshire wide developments that included information on the Staff Wellbeing Centres across NHS Ayrshire and Arran and Caring for Ayrshire Events taking place during November 2022; • North Ayrshire Developments that included the Social Work Leadership Event held on 30 September 2022, the launch of the ‘Our Community Space’ session in the Garnock Valley, the publication of the latest Foxgrove Art and Therapeutic Design Newsletter, an unpaid carers update and an update on the Self Directed Support Learning Review; and • An update on the Covid Social Care staff support fund. The Chair asked that those present publicise and promote to their staff the use of the Wellbeing Centres across North Ayrshire. Members asked questions and were provided with further information in relation to:- • Comms issuing a note in terms of the Gambling Workplace Charter awareness sessions taking place on 2 November 2022; • The National Care Service Forum message from Ministers in terms of no pre conceived approach; • The opening date for the Foxgrove facility which will be shared with the IJB once finalised; • The uptake from the public in terms of the Garnock Valley ‘Our Community Space’ sessions; • The approach to maximising community benefits as part of community wealth building; and • An Ayrshire-wide stakeholder event to be held late November/early December aligned to the publication of the new Creating Hope Together Strategy. Noted. 5. Woodland View Ward 7B Service Redesign Proposals and Future Models of Care Delivery Submitted report by Caroline Cameron, Director (NAHSCP) on the service redesign proposals with delivery of new model of care at Woodland View and wider community services in line with service demands and pressures, investment, national and local priorities. The report provided detail on the option appraisal recommendations and the proposal for use of Ward 7B as a 72 hour unscheduled care unit, delivery of an outreach rehabilitation model from Warrix Avenue and future planning for delivery of a CAMHS Assessment Hub, including staffing resource and funding details.
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The Board agreed to approve the options appraisal proposal for (i) use as a 72 hour Unscheduled care Unit; (ii) delivery of an outreach rehabilitation model from Warrix Avenue; and (iii) future planning for delivery of a CAMHS Assessment Hub 6. NAHSCP Workforce Plan 2022-25 Submitted report by Scott Bryan, Interim Programme Manager on the Workforce Plan for the NAHSCP for the period to March 2025. The Plan is due to be published by 31 October 2022 and sets out key challenges facing the HSCP workforce in North Ayrshire and identifies five local workforce priorities which are mapped directly to the Scottish Government’s workforce planning pillars. Appendix 1 to the report detailed the Final Draft of the Workforce Plan 2022-2025. Members asked questions and were provided with further information in relation to:- • Building on good practice in terms of employment of young people and those with lived and recovery experience; • The use of more pro-active wording within the action plan in relation to taking measures to utilise opportunities and the attraction and retention of staff; • The importance of succession planning guidance; • Barriers to be overcome in terms of inequalities; and • Progress oversight through the Staff Partnership Forum and update reports to the IJB. The Board agreed to (a) note the content of the Workforce Plan 2022-25; and (b) approve the Workforce Plan for (i) publication by 31 October 2022; and (ii) subsequent implementation. 7. Mental Welfare Commission Report – Authority to Discharge Submitted report by David Thomson, Head of Service (Health and Community Care) on progress in relation to the action plan developed in response to the Mental Welfare Commission – Authority to Discharge Report published in May 2021. A link to the full Authority to Discharge Report was provided in the report. Appendix 1 to the report detailed the North Ayrshire response to recommendations with Appendix 2 showing an example of an audit template. Noted. 8. Unscheduled Care Update The Board received a verbal update by Caroline Cameron, Director (NAHSCP) following on from the Unscheduled Care report presented to the IJB in June this year. The verbal update included information in relation to:- • Emergency Department (ED) attendances sustained at lower than pre-pandemic levels; • 4 Hour ED waits further deteriorated to 67.8% in September against a target of 95%; • ED 12-hour breaches significantly deteriorated and remain high with the worst reported figures for Ayrshire and Arran in July 2022; • ED admissions sustained at a reduced pre-pandemic level; • Length of stay has increased, particularly in University Hospital Crosshouse (UHC);
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• Delayed Discharges – overall numbers of patients remain lower than pre- pandemic levels, however occupied bed days and waits over two weeks have increased in the four-month period mainly in relation to a deteriorating position in South Ayrshire; • Covid inpatient numbers increased rapidly in July 2022 but have subsequently fallen back down during August; • Community unmet need has increased by 23% and there are now over 5,300 hours a week of unmet need for Care at Home across Ayrshire and Arran with this worsening position also in South Ayrshire; • None of the 138 additional beds open across UHC and University Hospital Ayr have closed and both sites frequently remain in Full Capacity Protocol resulting in additional beds open and patients in corridor areas awaiting admission. The Health and Care system in Ayrshire and Arran continues to be under extreme pressure through demand for services, across the health and social care system, in hospital and in the community. Work is continuing with a focus to support the pressures to de-escalate the system and reduce the risk to patients and communities. Since the report presented to the IJB in June, there have been a number of Discharge without Delay (DwD) events held to support the decongestion of the acute hospitals. These three and seven day events are held on both acute sites and involve both clinical and non-clinical staff, undertaking patient reviews and identifying issues blocking their progress through their treatment and a safe discharge. The three HSCPs have supported these events. Despite these events there has not been a de-escalation of the hospital sites nor a closure of any unfunded beds. A further two-pronged focussed intervention is planned for two weeks from 7 November involving the three HSCPs deploying community teams into the acute sites for two weeks to ‘pull’ patients to alleviate the immediate pressures in the hospitals alongside a simultaneous implementation of an acute ward process improvement model. Planning is underway for the intervention and a further update will be provided to the IJB in November. Additional information was also provided to the IJB on the delayed discharge position in North Ayrshire and an assurance of the plans in place to improve performance. In North Ayrshire the DD performance daily since January 2022 has averaged been between 50-60 delays with around 8-10 of those being Mental Health delays and around a third being AWI/guardianship, while these are not the same people and the list of patients delayed changes daily. The HSCP Director continually reviews the position to ensure anything that needs progressed or unblocked is taken forward as quickly as possible. An update on the position with regard to Care at Home was also provided. Noted. 9. Annual Delivery Plan Submitted NHS Board’s Annual Delivery Plan by Gillian Arnold, Head of Planning and Information. Noted.
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10. IJB Dates 2023 Submitted report by Karen Andrews, Team Manager (Governance) on the draft timetable for meetings of the IJB and the IJB PAC for 2023. Appendix 1 to the report detailed the full schedule of meetings. The Board agreed to approve the dates for meetings of the Integration Joint Board and the Performance and Audit Committee as detailed in the report. 11. Urgent Items The Chair agreed to consider the following item as urgent to allow the Board to receive up-to-date information. 11.1 CAMHS The Board received a verbal update in relation to performance information for CAMHS key performance standards regarding referral to treatment targets. In the last 3 and a half years the target has always been met, including during the pandemic. During the summer period from June to present there has been a peak in referrals resulting in reduced compliance. Referral totals include neuro development work from the service recently launched. An urgent mitigation plan has been put together to ensure compliance with the KPI target by January 2023 and the mitigation plan will be continually monitored. Members asked a question and were provided with further information in relation to neuro development and specialist assessments which are required. Noted. The meeting ended at 11.50 a.m.
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North Ayrshire Integration Joint Board – Action Note Updated following the meeting on 20 October 2022 No. Agenda Item Date of Meeting Action Status Officer 1. Unscheduled Care Performance 20/10/22 Verbal Report Provided to Meeting. Further report to be provided to meeting on 17 November 2022. Completed 17 November 2022 Caroline Cameron 2. Director’s Report 25/8/22 A future report to be provided to the IJB on suicides, drug and alcohol related deaths. Completed 17 November 2022 Caroline Cameron 3. 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. Date tbc Alison Sutherland 4. 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. Report to be presented to the IJB in December 2022. Thelma Bowers/Billy Brotherston 5 Director’s Report 25/8/22 A future report to be provided to the IJB on suicides, drug and alcohol related deaths. Report to be presented to the IJB in February 2023 specifically on suicide prevention Thelma Bowers
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6. Analogue to Digital 16/6/22 Further update on progress to be brought back to IJB. Update to be provided to IJB in February 2023 Kerry Logan