DirApp NAC 231213 IJB Review
North Ayrshire Council · 13 December 2023
Back to North Ayrshire Council — 13 December 2023 and its agenda
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NORTH AYRSHIRE COUNCIL 13 December 2023 North Ayrshire Council Title: Review of North Ayrshire IJB Scheme of Integration Purpose: To update Council on progress with the review of North Ayrshire Integration Scheme (“the Scheme”) further to the report to Council on 21 June 2023 Recommendation: Council is asked to (a) note the progress with the Review of the Integration Scheme by officers from each Council and NHS Board; and (b) agree to receive further updates as the review progresses. 1. Executive Summary 1.1 The Public Bodies (Joint Working) (Scotland) Act 2014 is intended to deliver adult social care and social work services and adult community health services in a joined- up way and is intended to achieve the National Health and Wellbeing Outcomes prescribed by Scottish Ministers. 1.2 The Integration Scheme is the legal agreement between North Ayrshire Council and NHS Ayrshire and Arran which sets out the arrangements for integration of health and social care, in North Ayrshire currently this is achieved through the Integration Joint Board (IJB) with services delivered by the Health and Social Care Partnership (HSCP). 1.3 There is a legal duty on the Council and Health Board (not the IJB) to review the Integration Scheme at least every five years to identify whether any changes are necessary or desirable. In June 2023 North Ayrshire Council agreed to review the Scheme of Integration and liaise in the process with East and South Ayrshire Council and NHS Ayrshire and Arran. This report provides Council with an update on progress with the review to date.
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2. Background 2.1 At the meeting on 21 June 2023, North Ayrshire Council noted that it had completed a review of the Integration Scheme in 2018 along with East Ayrshire Council. South Ayrshire completed their review the following year in 2019. Within the legislation, there is a statutory duty to review the Integration Scheme within a 5-year period to identify whether any changes are deemed necessary or desirable. The review must take into account integration planning principles set out in the legislation and to the National Health and Wellbeing Outcomes. North Ayrshire Council agreed to realign with the other Councils and undertake a review of the Integration Scheme in parallel with East and South Ayrshire Councils. 2.2 All three Councils and NHS Ayrshire and Arran are therefore undertaking a review of the Integration Schemes together. The June report to Council set out the process that parties required to follow for consultation with prescribed consultees after which the revised scheme will be presented to Council and NHS Board for approval. It will then be submitted to Scottish Ministers to formally approve any proposed changes to the Scheme. Progress 2.3 It was anticipated at that time that the review would conclude by December 2023. This deadline was recognised at the time to be challenging, particularly given the range of partners and stakeholders required to contribute to the review and to reach consensus on any areas of change. It is now the shared ambition of all parties to conclude the review by 31st March 2024. Structure 2.4 The process to undertake the review has been further discussed and agreed by the Ayrshire Chief Executives, supported by the IJB Chief Officers. A number of workstreams have been agreed and established to progress the review. 2.5 A Programme Board has been agreed to provide strategic oversight and ensure a consistent pan-Ayrshire approach can be taken where possible. The Programme Board is co-chaired by the Chief Executives of East Ayrshire Council and NHS Ayrshire and Arran. Membership includes the four chief executives, three IJB chief officers and the NHS Director of Transformation and Sustainability, a Scottish Government representative has also been identified to join the group in an advisory capacity. 2.6 The Programme Board will oversee the development of any proposals for change to the Integration Scheme emerging from the work of the four workstreams. The Programme Board may also make proposals regarding the future scope of the Integration Scheme for agreement by the Parties based on the provisions of Section 46 of the 2014 Act and this will include deciding the functions that are and are not to be delegated, taking full account of those functions which must be delegated under the terms of the legislation.
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2.7 The work of the review has been divided into four discrete workstreams with responsibility for the various prescribed parts of the Scheme delegated to each workstream. Chairing responsibilities are shared across the partners with representation from across all Councils, the NHS Board and HSCPs. The workstreams are outlined below: 1 – Resources – Chair - Head of Finance and ICT (East Ayrshire Council) The main focus for this sub-group is on workforce and finance, including financial risk sharing arrangements, but will also consider premises and support services. This group has met on several occasions and directed further exploratory work including around Prescribing, Support Service arrangements, Acute Set Aside resource, financial management arrangements and risk sharing. 2 – Governance and Legal – Chair - Head of Legal, HR and Regulatory Services (South Ayrshire Council) This workstream will consider local governance arrangements, information sharing and data handling, complaints handling and liability. The sub-group will also deliver an advisory role in terms of the legal competence of any proposed changes to the Integration Schemes. 3 – Care Governance – Chair - Associate Nurse Director/Lead Nurse (North Ayrshire HSCP) This sub-group will review clinical and care governance and risk management arrangements. 4- Communication and Engagement – Chair - Assistant Director, Engagement and Communications (NHS Ayrshire and Arran This final sub-group will consider the engagement elements within the Integration Scheme, and also lead on the engagement plan required to satisfy the requirements of the Integration Scheme review process, including engagement with the Prescribed Consultees set out in legislation. 2.8 All workstreams have now underway and will present any proposals within their workstream for changes to the Scheme of Integration to the Programme Board. It is unclear at this stage re the extent of any proposed changes and whether consensus will be reached on the same. 2.9 Any updated Integration Scheme will require to be approved by both North Ayrshire Council and NHS Ayrshire and Arran, as well as endorsed by the IJB, prior to submission to Scottish Ministers. Before submitting the revised Scheme for approval, the constituent authorities must consult again with the interested parties and undertake consultation on any proposed changes.
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3. Proposals 3.1 Council is asked to note the progress with work by officers from North Ayrshire Council and the HSCP alongside colleagues in South and East Ayrshire Councils and NHS Ayrshire and Arran to progress the review detailed above; 3.2 Note the revised target timescale of 31st March 2024 to complete the review; and 3.3 Agree to receive further updates as the review progresses. 4. Implications/Socio-economic Duty Financial 4.1 The delegation of any additional functions to the IJB must be accompanied by appropriate financial due diligence to ensure they are properly resourced. Appropriate risk sharing arrangements must be put in place. A financial assessment of the impact of any potential changes to financial arrangements will be shared with Council alongside any updated Integration Scheme presented for approval. Human Resources 4.2 None. Legal 4.3 Reviewing the Integration Scheme is required to ensure ongoing compliance with the Public Bodies (Joint Working) (Scotland) Act 2014. Equality/Socio-economic 4.4 The Scheme of Integration is intended to achieve the National Health and Wellbeing Outcomes prescribed by Scottish Ministers. Environmental and Sustainability 4.5 None. Key Priorities 4.6 The Scheme of Integration supports the delivery of the strategic priorities of the Health and Social Care Partnership. Community Wealth Building 4.7 None. 5. Consultation
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5.1 The report outlines the ongoing engagement in place between North, East and South Ayrshire Council’s and the NHS Board. As yet no public consultation has taken place, this will be taken forward at the appropriate stage in the review. Craig Hatton Chief Executive For further information please contact Aileen Craig, Head of Democratic Services, on 01294-324125 Background Papers Council Meeting Paper 21 June 2023 - Document.ashx (cmis.uk.com)
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