3 - Minute and Action Note
North Ayrshire Council · 11 May 2023
Back to Integration Joint Board — 11 May 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 March 2023 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 Pamela Jardine, Carers Representative Vicki Yuill, Third Sector Representative Louise Gibson, IJB Irvine Locality Forum (Chair) Present (Remote Participation) Voting Members Adrian Carragher, NHS Ayrshire and Arran Christie Fisher, NHS Ayrshire and Arran Marc Mazzucco, NHS Ayrshire and Arran In Attendance (Physical Participation) Alison Sutherland, Head of Service (Children, Families and Criminal Justice) Thelma Bowers, Head of Service (Mental Health), HSCP David Thomson, Head of Service (Health and Community Care) Eleanor Currie, Manager, HSCP Michelle Sutherland, Partnership Facilitator, HSCP Kerry Logan, Senior Manager (Health and Community Care) Ruth Wilson, Team Manager (Democratic Services) Karen Andrews, Team Manager Hayley Clancy, Committee Services Officer Shannon Wilson, Committee Services Officer Diane McCaw, Committee Services Officer In Attendance (Remote Participation)
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Elaine Young, Head of Health Improvement/Assistant Director of Public Health (NHS) Scott Bryan, Strategic Planning, Policy and Inequalities Officer Apologies Iain Jamieson, Clinical Director 1. Apologies for Absence and Chair’s Remarks Apologies for absence were noted. The Chair thanked both Louise Gibson and Janet Davies for their contributions to the Partnership, and wished Louise all the best in her future career and Janet best wishes for her retirement. 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. 3.1 Matters Arising from the Action Note Updates in terms of the Action Note were detailed as follows:- • 2022-23 – Month 7 Financial Performance – Report on Dental Services – date to be confirmed. • The Promise in North Ayrshire Update on Progress – further progress report and action plan to be remitted to IJB following The Promise Conference in November 2022 – planned for May 2023. • Director’s Report – Suicides, drugs and alcohol related deaths – report to be presented to IJB in May 2023 specifically on suicide prevention strategy. Other elements covered in previous updates to IJB. • Analogue to Digital – Update to be provided to IJB on 11 May 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 Care Inspectorate webinar to be held on Tuesday 21 March on Use of Technology to Support People Experiencing Care, the United Nations Convention on the Rights of the Child (UNCRC), and Raising awareness on connection with Spotting Signs of Neglect and Self- neglect in Adults; • Ayrshire wide developments that included a skills and knowledge development event to support people who use cocaine, the Falls Link Worker Programme, and Pan Ayrshire work on Directions, with an update report scheduled for June 2023; and • North Ayrshire Developments that included the Income Advisor Project, the North Ayrshire Alcohol and Drug Partnership Development Day to be held on Wednesday 29 March in Saltcoats Town Hall, North Ayrshire Council having
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been recognised as a Carer Positive ‘Exemplary’ employer in Scotland, planning for the return of the Partnership Awards Ceremony to be held on Tuesday 20 June 2023 in the Volunteer Rooms, Irvine, the successful securing of staff accommodation on Arran, the use of the Care Opinion independent website, Care at Home Recruitment events taking place throughout March, the forthcoming change from Analogue to Digital, the creation of the Castleview Hub, and the positive Care Inspectorate Inspection Report for the Anum Cara Respite Service. Councillor Billings joined the meeting at this point. Members asked questions and were provided with further information in relation to:- • evaluation and monitoring regarding the Falls Link Worker Programme; • the standardised approach to Directions across the three Partnerships; • the positive Anam Cara Respite Service report from the Care Inspectorate; • the date clash for the Health and Social Care Partnership and Community Justice Ayrshire awards; • the success and cost effectiveness of recruitment advertising methods; • recruitment event attendance levels, where the Senior Manager undertook to provide attendance figures to the Board; • the move from analogue to digital, including robust plans for when digital devices are installed; and • the provision of advice to North Ayrshire Council Elected Members regarding spotting signs of neglect and self-neglect in adults. Noted. 5. Financial Monitoring Report – Month 10 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 with Appendix E showing the IJB reserves position in detail. Members asked questions and were provided with further information in relation to:- • the overspend on employee costs as a result of vacancy and long term sickness cover; and • the Dean Funding Pay Award, where further information will be provided to the Board. 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 £1.181m, (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 2.11 of the report. 6. Budget 2023/2024
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Submitted report by Paul Doak, Head of Service (HSCP Finance and Transformation) on the financial position of the partnership for 2023/2024, including the proposed delegated funding, service budget pressures, plans developed to set a balanced budget and the associated risks. A summary of the 2022/23 budget and net budget increase was detailed at Appendix A. Appendix B provided details of the service costs and demand pressures. Savings in relation to NAC and NHS commissioned services were outlined at Appendix C and Appendix D provided the NHS baseline uplift for 2023/24 on a managed basis. The budget and finance settlement funding letter detailing the requirements in relation to the level of funding to be delegated to IJBs in 2023/24 was detailed at Appendix E to the report. The Board received professional advice from the Chief Social Work Officer who advised that he was satisfied that arrangements were in place, or in development, to ensure the safe provision of social work services in the forthcoming year. Members asked questions and were provided with further information in relation to:- • the use of reserves and unallocated general fund balance to support the budget position throughout the year; • the likelihood of achieving the delivery of savings; • there being no current detail on any potential residential care review; • any potential risk to care services on Arran; • the removal of covid recovery funding from the budget; • monitoring absences and risks in terms of covid, with the IJB receiving sight of the ongoing position in this regard; and • the obligation to advise the public of ongoing pressures to systems. Elaine Young left the meeting at this point. The Board agreed to (a) approve the budget for 2023-24 for North Ayrshire Health and Social Care Partnership inclusive of all pressures, savings and reserves, noting that the funding position was subject to confirmation by NHS Ayrshire and Arran; and (b) note the risks associated with this budget. 7. Medium Term Financial Outlook 2023-2026 Submitted report by Paul Doak, Head of Service (HSCP Finance and Transformation) on the Medium-Term Financial Outlook for the period to 31 March 2026. Detailed information on the Medium-Term Financial Outlook 2023-2026 was set out at the Appendix to the report. The Board agreed to note the Medium-Term Financial Outlook and the potential financial position in years 2 and 3. 8. Strategic Risk Register Submitted report by Paul Doak, Head of Service (HSCP Finance and Transformation on the updated IJB Strategic Risk Register. Appendix A detailed the current Strategic Risk Register and an extract of the approved risk management strategy was attached at Appendix B to the report. Members asked questions and were provided with further information in relation to the potential to elevate the financial sustainability risk score in the future.
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The Board agreed to approve the updated IJB Strategic Risk Register. 9. HSCP Equality Outcomes Plan (2022-2025) Submitted report by Caroline Cameron, Director (NAHSCP) on the development of a focussed set of equality outcomes which more closely reflect primary service user groups. The full Equality Outcomes Plan 2022-2025 was detailed at the Appendix to the report. Members asked questions and were provided with further information in relation to:- • Care Experience being considered a Protected Characteristic in North Ayrshire; and • methods to ensure the inclusion of all characteristics within the equality outcomes. The Board agreed to approve publication and implementation of the Equality Outcomes Plan 2022-2025. 10. Primary Care General Medical Services Update Submitted report by Vicki Campbell, Head of Primary and Urgent Care Services providing an update on the provision of General Medical Services across Ayrshire and Arran. The report set out how General Practice is continuing to operate in the current challenging environment, and on how it will evolve and develop through the implementation of the Primary Care Improvement Plan. Members asked questions and were provided with further information in relation to:- • the provision of a more concise activity report being provided to IJB on a regular basis; • timescales for any roll out of digital services offered to GP practices, including those in the Garnock Valley; and • work to create a capital planning priorities list. The Board agreed to (a) note (i) the current position of Primary Care General Medical Services, and (ii) the progress of implementation of the new GMS Contract through the Primary Care Improvement Plan; (b) support the current projected balance of the Primary Care Improvement Fund for 2022/23; and (c) approve the transfer of funds from the Primary Care Improvement Fund and General Medical Services to the NHS Ayrshire & Arran Public Health Department for the delivery of vaccinations as set out in Section 3.5 of the report. 11. Primary Urgent Care Update Submitted report by Vicki Campbell, Head of Primary and Urgent Care Services providing an update on the provision of primary urgent care services through the Ayrshire Urgent Care Service (AUCS) and an update on the new pathways delivered through the service as a result of the introduction of the national Redesign of Urgent Care (RUC) Programme. Members asked questions and were provided with further information in relation to:-
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• the potential for providing a flowchart detailing how a patient would move through the system; and • the benefit of communicating to the public the work which is carried out in the background. The Board agreed to note (i) the progress of the Urgent Care agenda across Ayrshire and Arran; (ii) the new pathways introduced through the RUC Programme; and (iii) the increased activity within AUCS and proposal being progressed to sustain the successful person-centred delivery model and patient pathways. 12. Whistleblowing Update Submitted report by Karen Callaghan, Corporate Governance Co-ordinator, in relation to whistleblowing concerns raised in Quarter 2 (July-30 September 2022). Noted. 13. Urgent Items The Chair agreed to consider the following item as urgent to allow the Board to receive up-to-date information. 13.1 Implementation of the National CAMHS and Neurodevelopmental Specifications Submitted report by Caroline Cameron, Director (NAHSCP) providing an update on the implementation of the National CAMHS Specification and on work with partner services in the development of Neurodevelopmental Services for children and young people where there is no co-occurring mental health presentation. The Specification complements, and sits within, the Getting It Right for Every Child approach and aims to ensure that children and families receive the support and access to services which meet their needs at the earliest opportunity. Members asked questions and were provided with further information in relation to:- • reports continuing to be presented to the IJB Performance and Audit Committee reflecting the trajectories, demand and management of the service; • the requirement for communication to give confidence in terms of criteria and reporting; • the history in terms of referrals to the CAMHS service; • the presentation of a similar report to the South and East Ayrshire IJBs; and • a further update being provided to the IJB, potentially prior to the summer recess period. The Chair advised the Board that once Members had digested the information contained within the report, they should contact Thelma Bowers, Head of Service, Stuart McKenzie, Senior Manager for CAMHS or Dr. Helen Smith, NHS Ayrshire and Arran direct with any outstanding questions not dealt with at the meeting. The Board agreed to note (a) the successful implementation in Ayrshire and Arran to meet the National CAMHS Specification, noting the ongoing demands and risks placed on the services in terms of accepting referrals for young people that do not meet the national criteria and specification; and (b) that work with partners will be taken forward through the 3 NSCHs in Ayrshire and Arran to progress whole system
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plan(s) to meet the National Neurodevelopment Specification, while referrals not meeting the CAMHS specification will cease to be accepted by CAMHS from 1 August 2023. In terms of Standing Order 6.8. the Chair agreed that the meeting be adjourned at 12.25 p.m. for a comfort break. The meeting reconvened at 12.35 p.m. with the same Members and Officers present and in attendance. 14. Exclusion of the Public – Paras 6, 9 and 10 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 6, 9 and 10 of Part 1 of Schedule 7A of the Act. 15. Care at Home Review Submitted report by Kerry Logan, Senior Manager on the Care at Home Review. The IJB, while noting the concerns raised by Councillor Billings in terms of the recommendation, agreed to the proposal for Option 2 as outlined in the report. 16. Valedictory The Board was advised that Robert Martin would be retiring from his role on the NHS Board and expressed its thanks and appreciation for his outstanding contribution to the work of the Partnership, from his involvement during the Shadow year to present. Individual Board Members addressed the meeting and wished him well with his retirement. The meeting ended at 1.20 p.m.
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North Ayrshire Integration Joint Board – Action Note Updated following the meeting on 16 March 2023 No. Agenda Item Date of Meeting Action Status Officer 1. 2022-23 – Month 7 Financial Performance 15/12/22 Noted that a report on dental services would come to a future meeting of the Board for Members’ consideration. Planned for 24th August 2023 Michelle Sutherland (via East HSCP) 2. 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. Planned for June 2023 Alison Sutherland 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 May 2023 specifically on suicide prevention strategy. Other elements covered in previous updates to IJB. Action now closed. Thelma Bowers 4. Analogue to Digital 16/6/22 Further update on progress to be brought back to IJB. On agenda IJB meeting11 May. Action now closed. Kerry Logan
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5. 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. Date tbc Caroline Cameron / Thelma Bowers