Minute and Action Note
North Ayrshire Council · 15 December 2022
Back to Integration Joint Board — 15 December 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 17 November 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 Timothy Billings, North Ayrshire Council 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 Stakeholder Representatives Louise McDaid, Staff Representative (North Ayrshire Council)/Chair, North Coast Locality Forum Present (Remote Participation) Voting Members Adrian Carracher, NHS Ayrshire and Arran Christie Fisher, NHS Ayrshire and Arran Marc Mazzucco, NHS Ayrshire and Arran Professional Advisers Iain Jamieson, Clinical Director Dr Louise Wilson, CP Representative Stakeholder Representatives Pamela Jardine, Carers Representative Vicki Yuill, Third Sector Representative In Attendance (Physical Participation) Elaine Young, Head of Health Improvement/Assistant Director of Public Health (NHS) Alison Sutherland, Head of Service (Children, Families and Criminal Justice) David Thomson, Head of Service (Health and Community Care) Hayley Clancy, Committee Services Officer Diane McCaw, Committee Services Officer In Attendance (Remote Participation) Billy Brotherston, Independent Chair of ADP
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Eleanor Currie, Manager, HSCP Michelle Sutherland, Partnership Facilitator, HSCP Ruth Wilson, Team Manager (Democratic Services) Apologies Thelma Bowers, Head of Service (Mental Health), HSCP 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/Action Note The accuracy of the Minutes of the meeting held on 20 October 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:- • Unscheduled Care Performance – Complete. • Director’s Report – Suicides, drugs and alcohol related deaths – Complete. • 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 presented to IJB in December 2022. • Directors Report: Suicides, Drug and Alcohol Related Deaths – report to be provided to IJB in February 2023, specifically on suicide prevention. • Analogue to Digital – Update to be provided to IJB in February 2023. Noted. 4. 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 Independent Review of Inspection, Scrutiny and Regulation (IRISR) and the call for evidence to support the review, and the Mental Welfare Commission Adults with Incapacity Monitoring Report 2021-2022 published on 27 October 2022; • Ayrshire wide developments that included the publication of the MAPPA Annual Report 2021-22 for the South West Scotland area, the 14-day Whole System
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event sponsored by the three Ayrshire directors of Health and Social Care Partnerships, securing UNICEF Baby Friendly Gold Achieving Sustainability accreditation; and • North Ayrshire Developments that included the commencement of a Care at Home service recruitment programme, the expansion of the Money Matters Service pilot where Income Advisers work with GP practices, approval of the plans for Foxgrove, the official opening of Red Rose House and Roslin House in Stevenston, the final handover session at Trindlemoss in relation to the Glasgow School of Art project, and the opening of Harper House National Specialist Family Service based in Saltcoats. Members asked questions and were provided with further information in relation to:- • the expansion of the Money Matters work with GP practices, supported by Improvement Service funding; • a report to Cabinet at the end of November on the review of financial inclusion services; and • future discussion on the Breastfeeding Network funding. Noted. 5. North Ayrshire Alcohol and Drug Partnership (ADP) Annual Report 2021- 2022 Submitted report by Billy Brotherston, Independent Chair of ADP on the North Ayrshire Alcohol and Drug Partnership’s Annual Report. The full report, submitted to the Scottish Government, was attached at Appendix 1 to the report and outlined the contribution to achieving the key outcomes and ministerial priorities. The Annual Report detailed all sources of income which the ADP received and provided information on the monies spent to deliver the priorities set out in the ADP Action Plan. Members asked questions and were provided with further information in relation to:- • the re-introduction of the bottle marking scheme in licenced premises and on information to be provided to the IJB on the effectiveness of the scheme; • support provided by the Team in terms of gambling addiction; • the future establishment of a Lived Experience Panel; • the number of children and young people affected by drug and alcohol problems; • the future recommencement of the Licensing Forum; and • the requirement to produce an annual self-assessment in terms of performance. The Board agreed to note the Annual Report attached as Appendix 1 to the report. 6. Financial Monitoring Report – Month 6 Submitted report by Paul Doak, Head of Service (HSCP Finance and Transformation) on the IJB’s financial performance, including an update on the estimated financial impact of the Covid-19 response. 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 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
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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 repayment of the debt to North Ayrshire Council by the end of the current financial year; • the underspend in purchase care and overspend within the inhouse care at home service; • the vacancy savings in terms of Integrated Island Services; and • the current position in terms of savings targets and on what is reflected in the year-end position. The Board agreed to (a) note (i) the overall integrated financial performance report for the financial year 2022-23 and the current overall projected year-end underspend of £0.051m, (ii) the progress with delivery of agreed savings, (iii) the remaining financial risks for 2022-23, including the impact of remaining Covid-19 estimates and costs; and (b) approve the budget reductions which were detailed at paragraph 2.12 of the report. 7. Financial Outlook Submitted report by Paul Doak, Head of Service (HSCP Finance and Transformation) on the financial outlook of the Partnership for 2023-24 and provided information in relation to the scale of any potential budget gap prior to the budget being submitted to the IJB for approval in March 2023. Information provided included three different scenarios for the potential budget gap, based on anticipated cost pressures and different funding assumptions and also gave an updated position in terms of reserves, highlighted the associated risks and the timetable for setting next year’s budget. Members asked questions and were provided with further information in relation to:- • the use of unearmarked reserves as part of the budget settlement; and • clarity in terms of where any savings will be made ie Council or NHS. The Board agreed to note (i) the financial outlook for 2023-24; and (ii) the ongoing work to allow a balanced budget to be presented to the IJB for approval in March 2023. 8. Unscheduled Care Update Submitted report by Caroline Cameron, Director (NAHSCP) following on from the Unscheduled Care report and verbal update presented to the IJB in June and October respectively this year. The report included information in relation to:- • the responsibilities of the IJBs in commissioning and oversight of performance in terms of Unscheduled Hospital Care in relation to the Acute Set Aside resource; • ongoing areas of concern in relation to performance detailed at section 1.4 of the report; • delegated services and set aside resources; • the impact of the operation of acute capacity at both University Hospital Crosshouse and University Hospital Ayr leading to additional financial and workforce pressures;
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• the Whole System Intervention taking place across both sites from 7 November until 20 November 2022; • the establishment of a programme of work with the aim to improve patient experience and outcomes; • emergency department attendances and wait times; • delayed discharge statistics and limitations in relation to community capacity in Care and Home and Care Home services; • the ongoing programme of recruitment within the Care at Home service; • discharge without delay events to support the decongestion of the acute hospitals; and • winter planning for all three Partnerships. Members asked questions and were provided with further information in relation to:- • the impact on staff from what is reported in the media; • the continued commitment of the Social Work service to address the risk regarding unmet need across the system; • any evaluation of the 14-day exercise going forward; and • the importance of Power of Attorney campaigns. The Board agreed to note (i) 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 ED compliance standards for which the IJB should receive ongoing performance updates; (ii) 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; and (iii) the North Ayrshire plans in relation to Winter Planning and other actions being progressed to improve delayed discharge performance and hospital flow. 9. Primary Care & Social Care Workforce Health & Wellbeing Update Submitted report by Caroline Cameron, Director (NAHSCP) on the Staff Wellbeing Programme. Information provided included key areas identified as local priorities and updates in terms of support for teams to ‘take a step back’ together and participate in wellbeing opportunities, mindfulness interventions and support and management of distress and anxiety, post-traumatic stress disorder, bereavement and staff affected by ‘long-Covid’. The Partnership Senior Management Team endorsed a proposal to set aside additional funding of £250,000 to continue the staff wellbeing programme for the next two years, to be funded from earmarked reserves in place from Winter Funding. Members asked questions and were provided with further information in relation to:- • the additional funding in the sum of £250,000, which is reflected in the budget position; and • sharing of best practice between the three Ayrshire Councils. The Board agreed to (a) note the content of the report and support the ongoing development and delivery of the Staff Wellbeing Programme; and (b) approve the continuation of funding for two years, setting aside £250,000 from the Winter Funding carried forward from 2020-21. 10. Exclusion of the Public – Paras 8 and 9
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The Committee resolved in terms of Section 50(A)4 of the Local Government (Scotland) Act 1973, to exclude from the Meeting the press and the public for the following item of business on the grounds indicated in terms of Paragraphs 8 and 9 of Part 1 of Schedule 7A of the Act. 11. Island Accommodation Submitted report by the Paul Doak, Head of Service (HSCP Finance and Transformation) on Island Accommodation on Arran. The IJB agreed to approve the proposal as outlined in 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 17 November 2022 No. Agenda Item Date of Meeting Action Status Officer 1. 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 2. 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. Complete – on agenda December 2022. Thelma Bowers/ Billy Brotherston 3. 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 4. 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