ITEM 14.1 IJB Directions Policy 2025
North Lanarkshire Council · 19 March 2025
Back to Health and Social Care Integration Joint Board — 19 March 2025 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
Page 1
ITEM 14.1 Version Control Date Summary of Changes 1 20/03/2023 North Lanarkshire Integration Joint Board DIRECTIONS POLICY
Page 2
Contents 1. Purpose and Scope .......................................................................................................................... 1 2. Policy Aims ...................................................................................................................................... 1 3. Legislative/Policy Framework ......................................................................................................... 1 4. Definition and Purpose of Directions .............................................................................................. 2 5. Policy Implementation .................................................................................................................... 2 6. Monitoring and Review ................................................................................................................... 3 Appendix 1: Directions Procedure .......................................................................................................... 4 Appendix 2 :Process for Issuing Directions ............................................................................................. 5
Page 3
1. Purpose and Scope This policy sets out the process for formulating, approving, issuing and reviewing directions from North Lanarkshire Integration Joint to NHS Lanarkshire and North Lanarkshire Council. This policy has been developed in line with the Public Bodies (Joint Working) (Scotland) Act 2014 and Scottish Governments Statutory Guidance on Directions from Integration Authorities to Health Boards and Local Authorities. The Public Bodies (Joint Working) (Scotland) Act 2014 places a duty on Integration Authorities (IJBs) to develop a strategic commissioning plan, for integrated functions and budgets under their control. An Integration Authority requires a mechanism to action their strategic commissioning plan, this mechanism takes the form of binding directions from the Integration Authority to one or both of NHS Lanarkshire and North Lanarkshire Council. Directions are also the means by which a record is maintained of which body decided what and with what advice, which body is responsible for what, ad which body should be audited for what, whether in financial or decision making terms. In January 2020, the Scottish Government issued Statutory Guidance on Directions from Integration Authorities to Health Boards and Local Authorities. The North Lanarkshire Joint Board must issue a direction in respect of every function that has been delegated to it by NHS Lanarkshire and North Lanarkshire Council which must provide relevant budget information. Directions are the means by which the IJB informs the Health Board and the Local Authority what is to be delivered using the integrated budget and for the IJB to improve the quality and sustainability of care, as outlined in its strategic commissioning plan. Directions are also the legal basis on which the Health Board and Local Authority deliver services that are under the control of the IJB. 2. Policy Aims This policy seeks to enhance governance, transparency and accountability between the IJB, NHS Lanarkshire and North Lanarkshire Council by clarifying responsibilities. This policy has been developed to ensure compliance with the Scottish Governments Directions from Integration Authorities to health boards and local authorities: statutory guidance. 3. Legislative/Policy Framework The Public Bodies (Joint Working) (Scotland) Act 2014 states that an Integration Joint Board must give a direction to constituent authority to carry out each function delegated to Integration Authority. Revised statutory guidance on directions was issued by Scottish Government in January 2020. This statutory guidance has informed the development of this policy, to ensure that the IJB can meet the key requirement of the guidance to improve governance, transparency and accountability between all partner organisations.
Page 4
4. Definition and Purpose of Directions It is essential that directions are understood to be the end point of a process of decision making by the IJB. Directions should not contain surprising or completely unknown information about service change or redesign and should follow a period of wider engagement on the function(s) that are the subject of the direction. This should normally be part of the service planning and design phase of strategic commissioning. Directions are legally binding, which is why they come at the end point of a process of planning and decision making. The delivery partners are required to comply with all directions received from the IJB, and the law is clear that they may not amend, ignore, appeal or veto any direction. Neither NHS Lanarkshire nor North Lanarkshire Council may use resources allocated via the Integration Joint Board in pursuit of a direction for any other purpose than that intended. The content of Directions should be sufficiently detailed to ensure the intention of the IJB is adequately captured. Directions should include information on the required delivery of the function and the financial resources that are available for carrying out the function. Directions may specify what the Health Board, Local Authority or both are to do in relation to carrying out a particular function. Lack of detail in a direction may cause difficulties in performance monitoring and hamper the effective delivery of the function. To assist with monitoring and reviewing directions issued, the IJB may seek information from either the Health Board or Local Authority or both about the delivery 5 of a function that is the subject of a direction, including when issues are identified in implementation and delivery of a direction. Specific directions can be given to NHS Lanarkshire, North Lanarkshire Council, or both (Health and Social Care Partnership (H&SCP)) depending on the services to be provided. However, directions should not be issued unnecessarily and should be proportionate. A direction will remain in place until it is revoked, varied or superseded by a later direction in respect of the same function. In summary, the purpose of directions is to set a clear framework for the operational delivery of the functions that have been delegated to the IJB. All directions must be in writing. Functions may be described in terms of delivery of services, achievement of outcomes and/or the priorities set out in the strategic commissioning plan. 5. Policy Implementation This Policy has been developed in line with the Public Bodies (Joint Working) (Scotland) Act 2014, Scottish Governments Statutory Guidance on Directions from Integration Authorities to Health Boards and Local Authorities as published in January 2020. This Policy defines what a direction is and is underpinned by the Directions Procedure (Appendix 1) which supports the development of new and revised directions. Directions are informed by a number of factors, including but not limited to: • Content of the IJB Strategic Commissioning Plan • Specific service redesign or transformation programmes
Page 5
• Financial changes or developments • A change in local circumstances • A fundamental change to practice or operations. 6. Monitoring and Review Directions: The IJB has agreed that Directions will be monitored on a quarterly basis via the IJB Committee structure. This will ensure that the relevant Committee will assume responsibility for maintaining an overview of progress with the implementation of directions, via detailed reports, and escalating any issues to the IJB. A full set of directions, will be presented to the IJB at the start of the financial year following confirmation of budget setting arrangements, however, other directions will be brought forward throughout the year to reflect strategic developments and service transformation. Policy: This policy will be reviewed every two years by the IJB, or earlier if Scottish Government release further guidance.
Page 6
Appendix 1: Directions Procedure This procedure sets out the process for formulating, approving, issuing and reviewing directions for the North Lanarkshire Integration Joint Board to NHS Lanarkshire, North Lanarkshire Council or both constituent authorities. A process map is attached at Appendix 2 of this document. 1. Directions Directions are the mechanism by which the IJB delivers its Strategic Commissioning Plan. When a Direction is presented to the IJB, the report author must ensure that the content of the Direction include details of the function to which it is the subject of, budget information which has been delegated to deliver it, the impact on workforce, any legal or risk implications, impact on IJB outcomes, priorities or policy, details of consultation and an Equalities Impact Assessment if required. The final page of the report template (attached at Appendix 3) provides a standard format for outlining the requirements for each direction to be issued; all sections of this must be completed. Following approval at the IJB a Direction will then be issued on behalf of the Chief Officer to the Chief Executive of NHS Lanarkshire, the Chief Executive of North Lanarkshire Council, or both. This will take the form of a letter together with the IJB report, including Direction template. Directions will be copied to the Chair and Vice Chair of the NHS Board and the Leader and Deputy Leader of the Local Authority. Directions should be issued within 7 days of IJB approval where possible. The details of each Direction issued by the IJB are entered into the IJB Register of Directions. An update on Directions will be provided quarterly to the IJB. A Direction will remain in place until it is varied, revoked or superseded by a later direction in respect of the same functions. 2. Implementation and Monitoring of Directions NHS Lanarkshire and North Lanarkshire Council are responsible for complying with and implementing all directions issued by the IJB. As the issuing of directions is a legally binding process any issues with this should be brought to the attention of the Chief Officer. An annual report on all current Directions will be presented to the IJB.
Page 7
Appendix 2: Process for Issuing Directions If any of the following cicrumstances are detailed within the report being submitted to the IJB, then a direction should be issued as per process detailed below.. o Specific service redesign or transformation o Financial changes or developments o Strategic Commissioning Plan o Changes in local circumstances o Fundamental changes to practice or operations When issuing a direction consideration must be given to: • Scope and scale of function • Finance involved • Scale and nature of change • Timescale for delivery • Those impacted by the change - Patients - Service users Paper presented to IJB/IJB PFA for discussion IJB agree the directions required based on paper Directions issued to relevant partner(s) to carry out the functions relating to the directions Assurance provded via the IJB on the delivery of the function to which the Direction related to on a quartly basis
Page 8
- Carers - Local communities - Staff - Others
Page 9
Appendix 3 -Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number This will be provided by IJB Administration Support Team 2 Report Title Title of Report 3 Date direction issued by IJB Date of IJB meeting that direction was issued 4 Date from which direction takes effect Date of when the direction should begin to be implemented or date direction issued by IJB 5 Direction to: This can be either: - NHS Lanarkshire - North Lanarkshire Council - H&SCP 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) This can be provided by IJB Administration Support Team 7 Functions covered by direction List all the functions to which the direction related e.g. Occupational Therapy, Mental Health. 8 Full text of direction Detail what the authorities are being asked to carry out. 9 Budget allocated by Integration Joint Board to carry out direction Detail if any funding has been allocated by IJB to carry out direction. 10 Performance Management / Governance arrangements Directions will be reported to the relevant IJB committee quarterly and an annual report of all current directions presented to IJB. Detail if any other groups etc will be involved in the performance management of the direction e.g. Core/ SLT.
Page 10
11 Date direction will be reviewed Date at which the next review of the direction is due (e.g. at next IJB meeting).