ITEM 3 Minute - IJB - 19 June 2024
North Lanarkshire Council · 25 September 2024
Back to Health and Social Care Integration Joint Board — 25 September 2024 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 ITEM 3 Integration Joint Board Committee Minutes from a meeting held on Microsoft Teams on Wednesday 19th June 2024 at 9.30am-10.55am Present: Voting Members: Councillor Claire Barclay North Lanarkshire Nominated Councillor Councillor Bob Burgess North Lanarkshire Council Nominated Councillor Phillip Couser NHS Lanarkshire Nominated Non Exec Director Councillor Paul Kelly North Lanarkshire Council Nominated Councillor Councillor Anne McCrory(Chair) North Lanarkshire Council Nominated Councillor Brian Moore NHS Lanarkshire Nominated Non Exec Director Non-Voting Members: Professional Advisors Amanda Kilburn Chief Finance Officer North HSCP Ross McGuffie Chief Officer, North Lanarkshire HSCP Stakeholders: Margaret Gibb Interim Chief Exec, VANL Third Sector Rep Cathy McGinty NHSL Partnership/Staff Side Rep Harry Robertson Carer Representative Elizabeth Seaton (left 10.25am) Carers Together OFFICER IN ATTENDANCE: Stacey Anderson Support Services Project Manager Stacey Connor (Minutes) Governance Support Manager Morag Dendy Chief Officer Planning, Performance & Quality Mark Dell Communications Manager Diane Fraser Chief Officer Adult Social Work Services Peter McCrossan Director of AHPs Des Murray Chief Executive NLC Sharon Murray Interim Nurse Director NLHSCP Dr Josephine Pravinkumar Director of Public Health Dr Tyra Smyth General Practitioner (GP) Maggs Thomson (Left 10am) Head of Health North HSCP APOLOGIES: Paul Carey Audit Scotland Nauman Dar NHS Lanarkshire Nominated Non Exec Director Dr Kenneth Dagg Secondary Care Medical Practitioner
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2 Jann Gardner Chief Executive NHS Lanarkshire Alison Gordon Head of Children & Families & Justice Services CSWO of NLC Dr Lucy Munro Medical Director NL Fiona Owens Audit Scotland John Watson Employee Representative NLC Unison Siobhan White NHS Lanarkshire Nominated Non Exec Director Maria Williamson Senior Manager, Quality Assurance ACTION 1. Welcome and Apologies The chair welcomed everyone to the meeting and introductions were made; apologies were as noted above. 2. Declaration of Interests There was no declaration of interest made. 3. Minutes of IJB (27th March 2024) The previous minutes were agreed as an accurate reflection of the discussion. 4. Matters Arising/ IJB Action Log Matters Arising There were no matters arising. IJB Action Log Ross McGuffie updated the committee regarding the below actions: IJB Self-Assessment Report – Audit Scotland have re started the self- assessment work so looking to start this again, due to the changes in membership it is planned to discuss this at the liaison session in November to give new members some time to settle in. Improving Cancer Journey- Paper planned to be shared for IJB PFA in August. National Care Service- Update for mosaic is on today’s agenda. 5. Chief Officer Update Ross McGuffie provided the committee with a verbal update as follows: Running senior team walk rounds across different services which picks up on feedback from iMatter around visibility if the senior leadership team.
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3 Health promoting health service in acute is pushing a different way of working to take a more holistic approach for patients to have an improved way of life – links to the back to basics discussed at the June liaison session. Chryston has officially opened now and a future IJB will be held here, seeing opportunities for joint working already. A public health round table event was held on prevention to focus on population health and wellbeing. Locally have a public health action team established with a focus on obesity – starting to look at the key prioritises for all partners. Working on a whole system agreement for physical activity as part of this work. Held a development session with Strathclyde university to look at the work on going-looking at areas of potential development National NHS Scotland conference was last week Morag Dendy and others presented the work undertaken by the home assessment teams within Lanarkshire – taken half delayed discharge bed days out of the system. Regional planning session held to look at collaboration around regional planning – looking to push as much service delivery at a local level. Key priorities are around- oncology, vascular and diagnostics. Focus will be to reach 1410 delays nationally for delayed discharges this equates to 34.6 per 100 thousand of the population. Brian Moore asked how will the public health action team updates come through this committee. Ross McGuffie advised will work together to pull a whole system piece. Planning to establish an overarching steering group to look at the agenda as a whole to then commission workstreams to progress particular areas. The overarching group would report to the NHS board, council committee and IJB. Dr Josephine Pravinkumar added there is national learning that can be used to assist this as well. 6. Digital System Transformation- Mosaic A report was shared to detail the scale and scope of digital system transformation taking place across social work and social care and setting out the progress of the implementation and integration of the following digital products within North Lanarkshire: Mosaic – New Social Work & Social Care Case Management System CM2000 – Dynamic Scheduling System for Care at Home Services ELMS2 – Equipment Management System (Integrated Equipment & Adaptation Service) The project is entering a critical phase with a planned go Live date of October 2024 and further details of the project timeline are included within the paper. The digital system transformation activity taking place across the partnership is considerable and the key projects detailed within this report are all entering critical phases and will all go Live before the end of this calendar year. Each of the project teams continue to work with all stakeholders, including Senior Managers, front line
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4 staff and integrated teams across the partnership, to ensure a smooth transition as each produce goes live and to ensure the benefits outlined within the report are realised. The council digital team has done some work to look at the strategic approach in preparation of the system moving to the cloud. The team is in place and there are governance mechanisms to support delivering staff training for the new system. Information in section 5.11 of the report outlines the requirements of what is needed to run the service on a daily basis. Cllr Kelly asked will health staff have access to information with the new system and is there some flexibility to change the go live date if there are any issues. Morag Dendy replied the cloud based element of the system will allow access for health staff. In terms of the timescales there is some flexibility but there is close oversight with the governance of the programme as well as close relationships with the providers to manage any issues early on. Phillip Couser asked how do we ensure that this digital transition is not just a new IT package but transformational change. He added what reporting will come to this committee. Morag Dendy replied in terms of the transformational change this has been supported by a number of workshops to future proof the service in terms of practice particularly recognising that when SWISS became dysfunctional workarounds were discovered so acknowledge this going forward. For the data and reporting the performance team have been running reports and involved in the work which is reporting into the chief executive performance reviews. Brian Moore requested that at the next PFA committee can additional financial information be provided to give the committee the assurance needed as they have provided funding for the work; this was noted and Morag Dendy will progress. The IJB committee: i. Note the content of the report. ii. Acknowledge the progress made towards the implementation of new digital systems across the partnership, and their associated benefits. products. MD 7. Mental Health and Wellbeing Delivery Plan The Mental Health and Wellbeing Strategy Board and the majority of project groups were stood down in March 2020 due to the COVID-19 pandemic. Whilst Strategy delivery was restarted in January 2021, there was a further disruption over the summer of 2021 when all non-essential meetings were stood down owing to the pressure on services. Over the course of 2022, we were able to look forward, endeavouring to take advantage of the opportunities and experiences of working in different ways. All workstreams reviewed their delivery plans to ensure that they took account of the impact of Covid-19; build on our recovery plans and the new ways of working that have developed over the course of the pandemic, whilst retaining a focus on the vision and objectives set out in the original Lanarkshire Mental Health and Wellbeing Strategy.
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5 The report outlines the progress made across all Strategy workstreams and sets out our progress in developing a Mental Health and Wellbeing Delivery Plan for Lanarkshire aligned to Scotland’s Mental Health and Wellbeing, the new national Mental Health and Wellbeing Strategy launched in 2023 by COSLA and the Scottish Government. Ross McGuffie highlighted there are now 4 different workstreams from the original plan, a new programme of work around national suicide prevention plan and an annual recovery plan. Transformed the approach at emergency department pulled together community responses to reduce police responses to 68% and supporting individuals going through stress and distress; pulling together a national work shop on this. The next strategy will undertake a gap analyses against the national strategy to create an action plan which is Lanarkshire specific. Plan to bring next delivery plan back to the committee around September/ October Dr Tyra Smyth noted there are significant challenges in different areas of the system. Ross McGuffie responded to offer some assurance around work being undertaken to manage potential gaps. Phillip Couser asked will the current strategy be removed and replaced by the new action plan. Ross McGuffie advised when the plan runs out it will be replaced with the national plan and action plan supporting the work. The following recommendations were agreed: (1) Acknowledges the process and timeline to develop a Lanarkshire Mental Health and Wellbeing Delivery Plan aligned to the National, Scottish Government/COSLA Mental health and Wellbeing Strategy and separate Delivery Plan, both published in 2023; (2) Agrees to receive the final draft Delivery Plan for approval at its next meeting in September 2024; (3) Agrees that Delivery Plan will subject to the endorsement of South Lanarkshire IJB; NHS Lanarkshire Board; North and South Lanarkshire Councils; and North and South Lanarkshire Community Planning Partnerships. 8. Public Health Annual Report Dr Josephine Pravinkumar present the committee with the annual public health report. This year Dr Pravinkumar has taken the opportunity to reflect on key Public Health priorities which featured in the previous annual report 2021/22 and she has viewed this reflection through the “What we Said” and “What Happened” lens. The main theme of the report is around the work with anchor oganisations. Some of the things that public health has made progress with are as follows: • The cost of living plan actions has been incorporated into the NHS Lanarkshire anchor plan in order to ensure a streamlined approach. All oral health improvement programs and the National Dental Inspection Programme have been remobilised; NHS dental activity has continued to increase.
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6 Progress in the area of long-term conditions in 2023 in NHS Lanarkshire has included completion of a Test of Change (pilot) with regards to support for patients attending the respiratory laboratory to quit smoking, which has now been successfully incorporated into usual practice. Ongoing work around immunisations particularly for measles. Also looking at Hepatitis C and V elimination programs. Reflecting on priorities for heath promoting health services going forward. Next year will be looking at children and young people as a key focus of the report. Phillip Couser inquired do we have the ambition to pick some elements of the health survey results to focus our effort as part of the preventative work as can’t target everything. Dr Josephine Pravinkumar noted key focuses are around obesity work, tobacco control and cardiovascular elements. Dr Tyra Smyth asked where is the vision to progress the work within primary care. It was advised that there is a primary care vision session being planned to strengthen some of the primary care approaches. The Integration Joint Board Committee noted the following: (1) The lower life expectancy and higher premature deaths in Lanarkshire compared to Scotland, and inequalities in these figures across Lanarkshire, necessitates whole systems working as a key priority, applying multidisciplinary, interagency, and collaborative approaches to prevention, early intervention and ongoing care. (2) To support the delivery of the NHSL Anchor Strategic Plan, particularly taking a more inequalities focused approach to service delivery. (3) Strengthen opportunities to work with other anchors on common goals to support community wealth building which are evolving through working in partnership. 9. Winter Planning Business Case Report 2024 The report shared is to provide the Board with a final report on the Winter Planning Business Case activity. The Scottish Government allocated additional funding in 2021/2022 and 2022/2023 to increase capacity across the health and social care system. In February 2022, the North Lanarkshire Integration Joint Board approved a business case for the commitment of the additional funding, while also taking the opportunity to target nonrecurring reserves to implement a series of proposals. The original business case was costed at just over £20m with a range of proposals to enhance assessment and planning capacity across the partnership, increase the direct provision of supports and services across a range of organisations, and invest in key infrastructure supports to deliver the wider change agenda. Workstreams were established to implement plans and proposals against the following headings: • Home Assessment Team
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7 • Enhanced Integrated Rehabilitation Provision • Community Nursing • Increased Capacity Across Home Support Service • Assistive Technology Team • Hospital at Home • Building Capacity of Independent Sector Providers • Investment in Communities Progress has been achieved across all the workstreams within the business case, with enhanced capacity and improvements evident across a range of services and settings. Further work is required to ensure that the enhancements are further embedded within Enabling Hubs and the emergent. Cllr Kelly asked for some reassurance that we will be able to take forward the business case or will we need to consider additional funding sources. Morag Dendy responded now is an opportunity to shape services going forward and align resources to where there is the biggest impact. The IJB note the content of the report and endorse the achieved milestones and next steps set out in the report. 10. Unaudited North Lanarkshire IJB Annual Accounts 2023/2024 The unaudited annual accounts are tabled within the report shared and have been prepared in line with proper accounting practice but remain subject to audit by Audit Scotland. As prescribed by the Local Authority Accounts (Scotland) Regulations 2014 and in line with previous years, the unaudited annual accounts will be available for public inspection in the Council Office for a three-week period from Monday 1 July 2024 until Friday 19 July 2024 inclusive. The Regulations also require publication of the annual accounts on the North Lanarkshire IJB website. The unaudited annual accounts are therefore available online from Friday 28 June 2024 until the date the audited Annual Accounts are published. It is planned that the audited annual accounts will be signed off at the IJB on 25th September 2024. There will be a slight amendment to the list of risks to take into account a new risk around the pharmacy pressures within the prison service, this will be corrected before the accounts are published. Brian Moore noted significant underspend in mental health and addictions is there any risks of this money being reclaimed by Scottish Government (SG) in future if not spent. Amanda Kilburn advised there is a plan to spend the funds which SG are aware of. Awaiting confirmation for funding of 2024/25 have been advised 80% of letters will be issued in the first quarter. The following recommendations were agreed: (1) Approve the Annual Governance Statement and associated reports for inclusion in the statutory accounts;
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8 (2) Approve the unaudited North Lanarkshire IJB Annual Accounts 2023/24 at Appendix 1; (3) Approve the submission of the unaudited annual accounts to Audit Scotland; and (4) Acknowledge the arrangements for publications of the North Lanarkshire IJB Annual Accounts 2023/24 in line with the legislative requirements. 11. Membership Update A paper was shared to advise of the replacement of 2 Non-Executive Directors from NHS Lanarkshire and 1 elected member to the IJB and to confirm the appointment of a new IJB chair. The rules about IJB membership are contained in statutory instruments and reflected in the Integration Scheme. These state that Board members are appointed for three years unless their membership is terminated earlier. Membership can be renewed for further periods of three years at a time or a new member appointed. Elected members – North Lanarkshire Council All of the current elected members have been appointed within the three-year term of office. Furthermore, at the meeting of North Lanarkshire Council held on Thursday, 28 March 2024, it was agreed that Councillor Anne McCrory would replace Councillor Michael McBride on North Lanarkshire Health and Social Care Integration Joint Board taking effect from 28th April 2024. In addition to this Councillor McCrory has also been nominated as Chair. Non- Executive Directors – NHS Lanarkshire The NHS Lanarkshire Board reviewed its Non-Executive Directors portfolios and formally proposed the replacement of Mr Ally Boyle and Mr James Muir with Mr Nauman Dar and Ms Siobhan White. Mr Phillip Courser will remain a member of the board and Mr Brian Moore also, in addition to being the Vice Chair of the committee. Ross McGuffie recorded his thanks to the contributions of Cllr Michael McBride, Ally Boyle and James Muir. The IJB noted the updated membership. 12. North Lanarkshire IJB Governance Document Update 2024 The report provides an overview of the recently reviewed/updated governance documents in regards to reporting for the North Lanarkshire Integration Joint Board. A continuous review of the IJB governance documents/policy will commence across the financial year with updates regularly being provided to the
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9 IJB. The report focuses on the governance surrounding the Code of Conduct and Declaration of Interest, Directions and Record Management. The IJB committee: 3.1 Reviewed the updated IJB Governance Report. 3.2 Acknowledged that the Code of Conduct and Declaration of Interest Forms have been issued to IJB members for completion for 2024- 2025. 3.3 Approved the recommendation to include a Directions summary as a standing item on the IJB and IJB PFA Agenda. 3.4 Noted the review of the Records Management Plan of North Lanarkshire Integration Joint Board as part of the IJB Governance work plan for 2024-25. 13. Risk Management Report Following on from the risk report presented at the IJB meeting on the 27th March 2024, alongside the financial update report, it was agreed by the board that the Financial Challenges risk rating would increase from High to Very High. At the IJB PFA meeting on 22nd May 2024, the following risk changes were approved: Delivery of CAMHs service, risk rating reduced from High to Medium Ineffective Governance arrangements, risk rating reduced from Medium to Low. Unscheduled Care, risk rating reduced from Very High to High. Introduction of a new risk relating to pharmacy pressures within prison service rated high and adult social care (this risk is currently being developed). Following these changes there are currently two other risks rated as Very High on the IJB risk register. IJB 06/21 – Prescribing Activity and Costs IJB 01/21 – Financial Challenges There are six high rated risks on the IJB risk register. IJB 04/21 - Notional Set Aside Budget IJB 12/21 - Staff Health & wellbeing IJB 15/22 – Cost of Living IJB 16/22 – National Care Service IJB 19/23 – Service sustainability IJB 20/23 – Workforce sustainability IJB 21/24- Pharmacy Pressures within Prison Service IJB 12/22 – Unscheduled Care The IJB currently has 19 risks identified on its IJB risk register with 10 risks rated as high or very high. The IJB note the contents of the report which includes the latest version of the IJB risk register and a note of those operational risks highlighted by the
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10 Heath & Social Care North Lanarkshire partnership that impact upon delivery of IJB business. Following changes to the financial position across NHS Lanarkshire, North Lanarkshire Council and North Lanarkshire IJB agreed that the financial challenges risk is reviewed and consideration made to increasing the risk level of the risk from High to Very High. 14. Risk There were no new risk identified. 15. Date of Next Meeting 25th September 2024 2-4pm