03 - 2025-06-18 IJB - IJB Minute 19.03.2025
North Lanarkshire Council · 18 June 2025
Back to Health and Social Care Integration Joint Board — 18 June 2025 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 the meeting held on Microsoft Teams, Wednesday 19 March 2025 at 9:30am – 12:00pm PRESENT - Voting Members: Cllr Claire Barclay North Lanarkshire Council Nominated Councillor Cllr Bob Burgess North Lanarkshire Council Nominated Councillor Phillip Couser NHS Lanarkshire Nominated Non-Exec Director Cllr Anne McCrory (Chair) North Lanarkshire Council Nominated Councillor Cllr Paul Kelly North Lanarkshire Council Nominated Councillor Brian Moore NHS Lanarkshire Nominated Non-Exec Director Siobhan White NHS Lanarkshire Nominated Non-Exec Director Non-Voting Members: Alison Gordon Head of Children & Families & Justice Services CSWO of NLC Claire Rae Chief Officer, North Lanarkshire HSCP Dr Tyra Smyth General Practitioner (left 11.06) Officer In Attendance: Dr Adam Brodie Associate Medical Director MHLDA (left 10.15) Morag Dendy Chief Officer Planning, Performance & Quality Mark Dell Communications Manager Fiona Campbell Diane Fraser Head of Adult Social Care Hazel Gilmour NMAHP Frailty Consultant (Joined 10.30) (left 11.14) Joanne Jenkins Interim Nurse Director NLHSCP Cathy McGinty NHSL Partnership/Staff Side Rep (left 11.45) Helen McKee Care of the Elderly Consultant (Joined 10.38) (left 11.14) Thomas Moan Senior Manager – Community Solutions VANL Dr Lucy Munro Medical Director NL Nicola Scott Chief Finance Officer Alison Skiba Maggs Thomson Head of Health North HSCP Rose Walker (Minutes) Governance Support Manager North HSCP John Watson Employee Representative NLC Unison David Wood Chief Executive - Community Solutions VANL Dawn Wright Management Team Secretary, North HSCP Apologies: Michael Breen Director of Finance Nauman Dar NHS Lanarkshire Nominated Non-Exec Director Dr Kenneth Dagg Consultant in Geriatric Medicine, Acute Division / Secondary Medical Care Practitioner Iris Henzel Community Solutions VANL
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2 Martin Hill Chair NHS Lanarkshire Jacqui Jones Deputy Chief Executive and Director of Human Resources Des Murray Chief Executive NLC Peter McCrossan Director of AHPs Dr Josephine Pravinkumar Director of Public Health Harry Robertson Carer Representative Marie Rooney Associate Director of Nursing – MHLDA Maria Williamson Senior Manager, Quality Assurance 1. Welcome and Apologies The chair welcomed everyone to the meeting and introductions were made; apologies were noted as above. 2. Declaration of Interests There was no declaration of interest made. 3. Minutes of IJB (04 December 2024) The previous minutes were agreed as an accurate reflection of the discussion. 4. Matters Arising Brian Moore mentioned two issues for consideration on the action log relating to: 1) Mental health learning disability workforce issues and agency costs, to bring a future report 2) If there's any update on the reference to the single point of access in relation to assessment enquiries, as discussed in the context of the winter plan. Claire Rae responded; in regard to the request for assessment, the commitment from both North and South Lanarkshire is to aim for a once for Lanarkshire approach. We now have a single assessment form that we utilise both North and South and there is still work to be undertaken in terms of the process. David wood added where it mentions David Wood at appendix 3, reports interest to CBS Sector. It should state CVS, and not CBS. David asked that his attendance on previous meeting be noted.
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3 5. Chief Officer Update Claire Rae provided the committee with a verbal update as follows: Attended a meeting with the Scottish Government and the other HSCP Chief Officers regarding the National Care Service. Part one of the bill, which is legislative, won’t be taken forward at this time and discussions are ongoing around an advisory board. Claire will provide updates as discussions progress. CAMHS team continues to exceed the 90% RTT target. The team received a letter of thanks from Maree Todd MSP, Minister for Social Care, Mental Wellbeing and Sport, this month thanking them for their hard work to reach this significant achievement, especially as CAMHS nationally continues to be under sustained pressure. The TEC team has been shortlisted as a finalist in the Local Government Chronicle awards in London which will take place on 11th June 2025. This team are playing a significant role in helping more North Lanarkshire residents to live independently at home and remain in the heart of their communities through the use of technology. Complementing this, the council last week approved plans to roll out broadband to all council houses, more than 37,000 homes across North Lanarkshire, over the next five years which evidence shows will have health and socio-economic benefits. Claire advised along with IJB chair Ann McCrory and Brian Moore, vice chair, visited the FNC+ base at Kirklands Hospital. The service brings together health and Scottish Ambulance Service staff to ensure only people with the greatest need are admitted to hospital and that people can be treated or cared for in the community, through the likes of Hospital @ Home, where possible. There is further work we can do as a partnership with FNC+ across both health and social care services Had a visit from the unscheduled care team within the Centre for Sustainable Delivery, looking at the processes within Acute hospitals. The report received will be validated and circulated with the recommended actions taken forward No comments received from IJB members. 6. Mental Health Strategy – Adam Brodie The NHS Lanarkshire Mental Health and Wellbeing delivery plan continues to progress effectively, aligning with Scotland’s National Mental Health and Wellbeing Strategy. Major accomplishments include: ▪ Specialised Mental Health Services: Establishment of dedicated teams such as the Community Perinatal Mental Health Team, Infant Mental Health Team, and Maternity and Neonatal Psychological Interventions Service ▪ Unified Neurodevelopmental Service: Streamlined care pathways for children and young people, combining multiple referral pathways into one unified approach ▪ Choices & Partnership Approach (CAPA): Implemented within Child and Adolescent Mental Health Services (CAMHS), this model ensures efficient patient management and better planning of service capacity ▪ Enhanced Support in Critical Settings: Improved mental health support in Emergency Departments, Custody Suites, and prison healthcare facilities, reducing response times and enhancing care quality
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4 ▪ Digital Innovations: Expansion of the Near Me virtual consultation platform, enabling greater accessibility to mental health services, along with improved feedback mechanisms from patients and families Through the Strategic Commissioning Plan, we are reviewing structures with updates being shared at future IJB meetings. Cllr Barclay commented on the increase in statistics of young people coming forward having mental Health issues; that their does not appear to be a stigma attached to talking about their own Mental Health and asked could this could be part of the rise. Dr Adam Brodie agreed this is positively the case, and can be seen as far back as 2010 coinciding with the growth of social media. Cllr Barclay made reference to the reduction in the police attendance to the emergency departments; noting 82% is positively good and asked is that something that can be said is brilliant, or is it because of all the other things that have been implemented. Also asked if the proper procedures are being followed. Dr Brodie advised it is the same people, who would have been in contact with Police Scotland that come to the emergency department; it is just being managed in a different and more collaborative way. Cllr Barclay referred back to discussions from the previous meeting regarding the communications around CAMHS which indicated a rate of 90%. Cllr Barclay made reference to some of the responses on social media in which people had expressed had still not been seen and that an18-week’s waiting time is considered too long; Cllr Barclay queried if communications will be issued as a pathway to address. Claire Rae advised Mark Dell, is currently addressing this matter, and communication will be provided regarding signposting for individuals involved. Phillip Couser commented on the strategy layout; and mentioned with that focus on good mental health for all, asked do we have enough investment in that space? referring to the needs assessment diagram listed within the report; with this sitting in the middle; thought that this should sit up front. Phillip raise questions where are we now? What's changed in terms of what drivers of demand and across the population? Dr Brodie discussed with respect to the preventative work versus treatment, this is always a huge issue which sometimes brings challenges. CAMHS in general and a lot of work that comes out of treatment services in some ways, preventative, is clearly part of the purpose of young people's services; to try and stop things from progressing to a lifelong condition where possible and to minimise the impact on people and their families. Discussed in terms of the wider work, the good mental health; it is about resilience and about tools of connectedness in the community and about increased awareness and knowledge and trying to break that cycle. It is always a challenge weighing up the preventive work, which might not produce any immediately accessible information, or outcomes. Dr Lucy Munro added around young people; the risk that we have may over medicalise mental distress or a lack of mental well-being or these that excuse to go with a medical
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5 model, it’s an incredibly complex area where we all have to work together and that's why have a mental health and well-being strategy. Siobhan White asked around the achievement framework (appendix 2) in relation to the outputs; asked how we are going to measure in terms of capacity for completion. Is this something that will be measured frequently in terms of monthly, or every 6 months. Maggs Thomson advised this is a work in progress; what is being seen is the starting point. We are on the journey of moving from the Mental Health and Well-being strategy to delivery, and implementation. We are moving towards a new governance structure, and will be building those repositories for this type of information. David Wood commented discussed the fourth phase of the community health and well- being funds been recently allocated to 40 organisations across North Lanarkshire and they will start delivery from the 1st of April 2025. David advised Scottish Government will continue the funding for phase five this year, and for phase six 2027/8. David Wood referred to the following points within the report: 1) Paragraph 4.8 where mentioned about the primary care mental health and well- being team's approach under review. David sought clarity in that we would welcome the opportunity for, Community, voluntary sector organisations to participate in that review as well. 2) Noted 4.14 paragraph. Where mentioned many children and young people support and access to services meet their needs, likely to be community based and should be quickly and easily accessible. David emphasised the importance and value of CVS organisations, delivering community based support for children, young people and families and just an example projects funded through children, young people and families, community mental health and well-being fund, highlighted supported 2000 young people and 160 families in North Lanarkshire towards scenario outcomes in Facebook. IJB Committee note and agreed the following recommendations: I. 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 II. Through the Strategic Commissioning Plan, we are reviewing structures and will provide an update at future meetings The IJB agreed and acknowledged the recommendations 7. Prisoner Healthcare Maggs Thomson provided IJB with an update on Prisoner Healthcare in HMP Shotts Prison. Discussed the continuing health service improvements undertaken within the prison and on- going work around the National Target Operating Model and next steps. The model was implemented to deliver excellence in health care to the people who live within HMP Shotts, and has delivered on all Service Model Review recommendations. The 2022
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6 HIS review led to 64 recommendations of which there are only 2 outstanding in relation to pharmacy and these are part of the ongoing pharmacy review. Noted that the two outstanding pieces of work ongoing now fall into the realms of the target operating model and the key areas that have been identified for that operating model which has given the platform for the next areas of improvement; these are noted throughout the paper. Main areas of concern 1) The financial environment. whilst there is a lot of good work; currently there is a £600,000 challenge around the national contract for pharmacy; for the provision delivery and distribution of medicines, this is a cost pressure that didn't have a number of years ago. On a positive note there is ongoing work within the clinical teams working alongside the management colleagues and finance colleagues to try and make efficiencies around prescribing and bring costs down. 2) Prisoner behaviour and illicit drug use in the prisons; seeing a more complex mix of drugs being available in the prison and seeing some significant impact in terms of people's health and requiring a hospital transfer. Next Steps ▪ Continue to provide service delivery as per new model ▪ Continue to work collaboratively with SPS ▪ Continue progressing to achieve the National Target Operating Model ▪ Represent the Prison Healthcare service at finance cluster review meeting ▪ Complete MAT standards benchmarking and evidence gathering ▪ Continue to develop the workforce and role diversification Bob Burgess inquired whether a portion of the £600,000 is being allocated for the support of individuals with substance use issues in the prison, and asked what initiatives are in place to address mental health. Maggs Thomson informed the £600,000 relates to a contractual relationship with the provider. It is not about the drugs costs themselves. This includes a management fee, the delivery and production of getting the medication to the prison. Advised in terms of the broader discussion around people with mental health and substance use issues, there is absolute connectivity; it is about touching on that health improvement side of how much work can we do with prisoners that tries to navigate them into a more positive space that they are less reliant on medication. That's the journey we want to be on and try to and that's where we're working with prison colleagues. But yes, there is a high use of methadone within the prison to manage those situations. Maggs discussed in regard to prisoners facing mental health and substance use challenges, there is a clear connection to our efforts in promoting health improvement. The objective is to explore how we can support in transitioning towards a more positive state that reduces their reliance on medication. Noted in terms of the provision of care in the prison; have a comprehensive care approach, which includes a mental health team, a substance use team, and a primary care team.
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7 Nicola Scott, Finance Officer confirmed this cost pressure has been addressed and forms part of the financial plan and is part of the budget gap reported. The plan is to look at service redesign and transformation to meet those cost pressures. Siobhan white, asked how long are we in to the contract, and will it be left up to individual IJB boards to negotiate their own contracts. Maggs Thomson confirmed that this is a national contract and is two years in. Brian Moore commented on the number of Emergency Department attendances; 185 linked to drug overdoses, pointing out this is more a national issue in terms of drugs getting into prisons. Noted the improved working relationships and multidisciplinary approach and strong emphasis on the well-being and significant improvements made in a short time period. Cllr Barclay raised question around transition period; if there are robust plans for individuals when being released from prison. Alison Gordon advised in North Lanarkshire, is supported by the ADP, and additional voluntary through care support. A nationally commissioned through care model is being adopted to ensure that there are no gaps in support for specific categories of prisoners or in particular geographical areas. The practical implementation and effectiveness of this approach is still to be observed and how it will impact. It is recommended that the IJB note the contents of the report. I. that the IJB recognise the service changes and continuous improvements made within prisoner healthcare at HMP Shotts in accordance with the recommendations made by HIS II. that the IJB recognise the service changes and continual improvements made within prisoner healthcare at HMP Shotts in accordance with the local recommendations and actions identified in the Local Service Model review, including the efforts made by the AHSU to address the recruitment & retention issue within Prisoner Healthcare III. It is recommended that the IJB endorse the future work streams of the Prisoner healthcare team and to achieve all recommendations within the National Target Operating Model The IJB noted the contents of the report 8. Annual chief Social Work Officer Report – Alison Gordon Alison Gordon provided an overview of the report and advised in line with Scottish Government guidance the Chief Social Work Officer (CSWO) is required to provide an annual report which provides an overview of social work service delivery in North Lanarkshire for the period April 2023 to March 2024. Noted the report reflects social work’s contribution to the Programme of Work underpinning the Plan for North Lanarkshire and covers the following areas: ▪ Governance and accountability arrangements, including partnership working
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8 ▪ Service Quality and Performance, including service developments ▪ Resources ▪ Workforce ▪ Future Priorities Key highlights ▪ North Lanarkshire Social Work’s ongoing role in safeguarding and supporting approximately 30,000 individuals and families, supported by a workforce of around 2,800 staff. ▪ Key areas include strong partnership working, early intervention, poverty reduction, and trauma- informed practices. The service continues to manage rising demands effectively, prioritising home and community-based care and improving transitions between child and adult services. ▪ External scrutiny of social work services is undertaken primarily through the Care Inspectorate and its partner agencies. In addition to ongoing inspections of regulated services, a Joint Inspection of Services for Children and Young People at Risk of harm in North Lanarkshire took place between April and October 2023 evaluating the impact of services on children and young people as ‘Very Good. ▪ This also identified a number of key strengths including collaborative leadership and the strong relational and trauma informed approaches which supported staff form trusting relationships with children, young people and their families. ▪ Recruitment initiatives have reduced staff vacancies, and innovation, especially digital engagement and user involvement, remains a priority. The report acknowledges upcoming financial challenges but highlights opportunities to enhance partnerships and further strengthen community- based support. Philips Couser asked what purpose are these reports serving, who is the audience and is this information being presented in the best way. Alison Gordon in response discussed what’s difficult is that we also report through different bodies and in different ways. Pointed out the advantages are having it within the one report. Is primarily to fulfil the requirements for governance and scrutiny in relation to social work services in terms of the audience it Is a public facing document and utilised to compile a national report. Brian Moore commented there being a need to improve our ability to evidence the preventative approach; that many of our services have not only in terms of impact but also in terms of trying to shift the balance between reactive services is something that's more preventative. Alison Gordon in response discussed one of the deliverables is around investing in prevention. it is an area of where It's integrated within the programme of work for the Council as well as the strategic commissioning plan, and through the resilient people programme of work, we are looking at the connection across both of these. It is recommended that the IJB note the contents of the report:
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9 I. the IJB consider and note the contents of the report II. that the report has been approved by Adult Care and Social Work Committee The IJB noted the contents of the report. 9. Frailty Strategy Update – Hazel Gilmour Hazel Gilmour, NMHAP consultant gave presentation of the Frailty Strategy Update. Since launching in early 2024, the NHS Lanarkshire Strategy for Preventing and Managing Frailty has achieved significant milestones aimed at improving support for older people at risk of, or experiencing, frailty. Significant progress has been made in implementing and embedding its initiatives across Lanarkshire. The report outlines the work completed to date and sets out the key next steps for advancing the strategy in 2025. Highlights include the establishment of Frailty Units at all acute hospital sites, the Carers Academy initiative in partnership with Alzheimer’s Scotland, Blantyre Life promoting independent living, and the introduction of Active Wards to encourage patient mobility and mental stimulation. This year, the Frailty Strategy is concentrating on three key areas: 1. Promoting health and wellbeing: Enhancing public access to frailty information for self- management and early detection 2. Tackling inequalities: Targeting engagement and improved frailty identification in communities with the highest levels of need 3. Delivering sustainable healthcare: Advancing frailty care pathways in our three hospitals and exploring technological innovations to support independent living A new governance structure, the Ageing and Frailty Programme Board, chaired by Claire Rae, is overseeing the implementation work, aligning closely with national priorities. Cllr Paul Kelly commented establishing the Ageing and Frailty board, is a really good step and is clearly aligned to our integration work. Cllr Kelly commented in relation the early intervention focus to the use of technology; that some of this will fall within different partners in different areas in terms of local authorities; asked is that the thought process. Hazel Gilmour in response commented it does span over a multitude of different areas. We have identified the importance of beginning with manageable objectives and ensuring that every initiative we undertake is meaningful and will make a significant difference and have a positive impact. Focus is about getting it right before we have that expansion over a multitude of different areas and we are committed to ensuring the quality of our ongoing work while maintaining momentum and keeping engagement with these partners.
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10 Helen McKee added the Rockwood Extra Clinical Frailty Scale is being utilised and there is evidence that carers are able to engage with it and use it. The plan is to enhance in a power of work with district nurses across the whole of North and South Lanarkshire to encourage engagement with CFS scoring and we are really trying to push that as an identification tool, in way of educational. Brian Moore commented it is encouraging to hear that we will have frailty units in our three acute sites. Brian raised the question, to how many people are using these units, how many elderly people are being diverted from Accident and Emergency through the units, and is there a timeline to utilise the units. Hazel Gilmour in response mentioned there is ongoing work happening to reduce hospital admissions. FNC+ is actively working across Lanarkshire with geriatricians to prevent people being hospitalised by utilising services like the Hospital @ Home and utilising community district nurse teams. Cllr Bob Burgess made reference to age; and asked how can we empower individuals to do their own thing, and what would a programme entail to do that. Hazel Gilmour discussed the Rockwood frailty score is a self-explanatory and descriptive tool, split into 9 categories; one being the person is extremely fit and nine being that they are probably within the end of their life. It encourages people to recognise Frailty. It is recommended that the IJB: I. Acknowledge the content of this report II. Acknowledge the Frailty work plan for 2025 The IJB acknowledge the contents of the report 10. Financial Plan Nicola Scott provided the IJB with an update of the medium term financial forecast position for 2025-2028 as set out in the Appendix Medium Term Financial Plan (MTFP) and Long Term Financial Outlook. Highlights ▪ Estimates a budget gap of £51.854m over the 3-year planning period 2025/26 to 2027/28, of which £14.729m relates to 2025/26. Therefore, to meet the requirement on the Partnership to set a balanced budget, a package of savings has been identified to meet the 2025/26 gap. Any in year shortfalls will be met by reserves, as permitted in the IJB Reserves Strategy. ▪ Have identified savings of almost £15 million for 2025/26, ensuring we remain financially balanced ▪ The Plan addresses future challenges such as inflation, staffing costs, increasing demand, and regulatory changes. By planning now, we'll effectively manage projected annual pressures of around £58 million by 2034/35 ▪ Financial and Operational risks will continue to be monitored
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11 Cllr Paul Kelly commented on the appendix, looking at 2025/2026 or £4.8 million of social care budget reductions and asked is there detail on specifically what it looks at and also is it going to have consequences. Nicola Scott replied the majority of that is savings that have already been made during 2024/2025 and this is the full year impact of those savings. Phillip Couser raised conversation relating to demographics of over 70% increase in the over 75s and asked do we have consistency of applications of assumptions across partnerships or are some partnerships taking a more pessimistic or possibly more optimistic view. Nicola Scott confirmed yes; as works closely with the Chief Financial Officer in South, therefore our assumptions align. Siobhan White commented on section 8; where it mentions ‘Our Response’ noting demonstrates the service redesign proposals to be implemented over the coming 12 months to address the £14.729m funding gap in 2025/26; and asked from the ones listed; how much ownership is there. Claire Rae replied it emphasises all the work that we have spoken about in terms of frailty identification and early intervention prevention; these are the estimated funds allocated to the areas currently working on. Siobhan White asked in relation to the Prison pharmacy contract; reacting to suddenly, if a contract goes wrong, where does that figure horizon scanning, in terms of the bigger element on our budget, and where can we obtain assurance from what is approaching. Nicola Scott in response advised assurance is obtained from various places, a lot of the information comes from the Chief Finance Officer Network who work closely with Scottish Government and COSLA and work closely with finance colleagues from NHS and North Lanarkshire Council (NLC). Catherine McGinty made comment to section 7.4 under redesign and asked that we be mindful when looking at vacancies the impact can have on staff where roles and jobs may not be required due to the service re-design. It is recommended that the IJB I. Acknowledge the assumptions and context of the Medium Term Financial Plan II. Approve the Medium Term Financial Plan 2025-2028 III. Approve the savings proposals to meet the savings gap in 2025/26 IV. Acknowledge the Long Term Financial Outlook for 2025-2035 The IJB acknowledged and approved the contents of the report.
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12 11. Delegated Health & Social Care Budget Nicola Scott advised the report is a statutory report detailing the financial allocation and budgets made available to the Integration Joint Board (IJB) for 2025/26 by North Lanarkshire Council and NHS Lanarkshire. It provides an overview of the IJB’s budget allocation for 2025/26, details the contributions which are allocated from both partners from NLC and NHSL and requests approval to accept the delegated budgets requested. The budgets are outlined within sections 8.4 and 9.4. It is recommended that the IJB: I. Agree to accept the delegated social care budget for 2025/26 in section 8.4 subject to any final adjustments in relation to recurring budget adjustments in March 2025 II. Agree to accept the delegated health budget for 2025/26 in section 9.4 subject to any final adjustments in relation to recurring budget adjustments in March 2025 and any further funding allocated by the Scottish Government III. Approve a drawdown of reserves, if required, in order to fund any shortfall in funding for 2025/26 IV. Acknowledge that both NHSL and NLC have passed through full budget uplifts as received from Scottish Government The IJB agreed to accept the delegated budgets and approved the drawdown of reserves. 12. IJB Reserves Strategy 2025-26 Nicola Scott gave overview of the IJB reserves Strategy and discussed the reserves utilised as required throughout the year, and projected at year end 31 March 2025. Focus points of discussion as below: ▪ Table 2 - risk based and contingency reserves are expected to be just over £30, million and are classed as the level of usable reserves ▪ Section 8 – The recommended value of risk based reserves is sitting at 5%. Noted at the time the report was written; it was slightly below the 5%. As the underspends within 2024/2025 continue to grow; it is expected to meet that 5% level. Nicola expressed she is comfortable 5% sets a good position going forward. Siobhan White asked regards the movement in reserves from the start of the year to the end of the year; is that kind of percentage movement of reserves normal or are we using a bit more this year. Nicola Scott in response discussed would normally use our reserves throughout the year and then this would be topped up at the yearend by government funding. Nicola advised the process has been altered by the Chief Financial officer in NHS this year directing to utilise the funding that we receive in year. What is received n 2024/2025, will used and any surplus will be put to reserves. As a result, there has been £10 million placed back into
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13 reserves following he drawdowns earlier in the year. Nicola informed by year end 31st of March 2025, the net position will be the same. Brian Moore commented in relation to Appendix 1, for 2025/2026, noticed there is not many indications about funding been drawn down specifically related to mental health (where there's significant reserves there in relation to a whole range of issues); CAMHS, alcohol and drugs, diagnostic support, dementia care and distress, and brief interventions. Brian suggested a more detailed discussion about each budget reserve and its potential future use. Nicola Scott advised the report that will be brought back at the end of June 2025 will offer a review with a more descriptive position. David Wood mentioned in terms of using reserves; asked if consideration could be given to utilising reserves to support the community voluntary sector. It is recommended that the IJB: I. Acknowledge the contents of the report. The IJB acknowledged the contents of the report 13. Risk Update Morag Dendy gave overview on the IJB risk update paper advising the IJB PFA Committee has delegated oversight and responsibility for financial and performance risks associated with the remit of the Integration Joint Board. The IJB currently has 19 risks identified on its IJB risk register with 11 risks rated as high or very high. The following risk are currently rated as Very High on the IJB risk register. • IJB 06/21 – Prescribing Activity and Costs • IJB 01/21 – Financial Challenges • IJB 21/24- Pharmacy Pressures within Prison Services The following risks are rated high 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 12/22 – Unscheduled Care
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14 • IJB 23/24- Speech and Language Therapy The High/Very High rated operational risks that have been identified as having or potentially having an impact on IJB objectives and/or delivery of services are highlighted within the Risk Overview Dashboard (Appendix 1) and Risk Register (Appendix 2). Philip Couser asked in relation to risk around financial sustainability regards demographics, if a specific risk is around demographics challenges rather than leading with financial Morag Dendy replied It is more implicit than explicit. The style of this will be something we will review further. Additionally, we need to consider how the risks are identified and incorporated into this report. Phillip Couser commented on the prescribing risk, within the context of the prison services it being very high, but for the IJB as a whole expressed his uncertainty of this being a very high risk. Phillip suggested the impact of it on its own, is just part of the wider financial challenges. Morag Dendy highlighted in terms of how the risks are identified and risk owners identified within NHSL and NLC, is helpful for us to go and consider the implications of change and how they are incorporated into our approach to risk management, as well as the impact this has on the IJB. Claire Rae advised the risk register will be revised and will proceed with developing this as part of IJB initiatives. It is recommended that the IJB note the contents of the report: I. a review of the highest rated risks within the IJB risk register and a note of those operational risks highlighted by the Heath & Social Care North Lanarkshire partnership that impact upon delivery of IJB business. II. to consider the inclusion of climate change risk to the IJB risk register to align risk sharing across parent organisations. The IJB noted the contents of the report. 14. IJB Directions Letters to NLC and NHSL The report seeks the approval of the IJB in regards to the issue of the directions to each partner for 2025/2026 in line with the Strategic Commissioning Plan and the IJB Financial Plan. In accordance with the requirements set out in the Public Bodies (Joint Working) (Scotland) Act 2014, the North Lanarkshire Integration Joint Board is required to issue a direction to Lanarkshire NHS Health Board and North Lanarkshire Council in respect of the delivery of integrated functions and how resources are to be allocated for the resultant services. The letters of direction are included within the report Appendix 1 and Appendix 2, following the approval of the IJB, will be issued to North Lanarkshire Council and Lanarkshire Health Board by 31st March 2025. The focus for the year ahead will be on implementation of the programme of work of the IJB’s Strategic Commissioning Plan 2023-26.
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15 It is recommended that the IJB approve the contents of the report: I. Approve the issue of the directions to North Lanarkshire Council for the financial year 2025/2026 attached at Error! Reference source not found. II. Approve the issue of the directions to Lanarkshire NHS Health Board for the financial year 2025/2026 attached at Error! Reference source not found. IJB members approved the contents of the report 15. NL IJB Integration Scheme 2025 The integration scheme is a requirement, by the Public Bodies Act. The Public Bodies (Joint Working) (Scotland) Act 2014 (thereafter known as the “Act”) requires Health Boards and Local Authorities to integrate planning for, and delivery of certain adult health and social care services. The Integration Scheme sets out the agreement through which NHS Lanarkshire Health Board and North Lanarkshire Council do this. The paper confirms Cabinet Secretary approval for the revised North Lanarkshire Integration Scheme for the period 2024 – 2029 confirmed in November 2024. The updated version reflects the outcome of the review and update process undertaken to meet the 5-year review timeline. This is the third report and encompasses the period from 2024 to 2029. There are minimal changes compared to the previous report, primarily focusing on an update of the hosted services and the description of services. The Integration Scheme is available on the NLC and NHSL websites. It is recommended that the IJB note the contents of the report: I. the Integration Scheme has Cabinet Secretary approval; II. the Integration Scheme is available on the HSCP website, Council website and NHSL website III. the paper will be presented to Policy and Strategy Committee on the 13 March 2025 The IJB noted the contents of the report. 16. IJB Chair Arrangements 2025-2028
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16 There were no new risks identified. Date of Next Meeting IJB – 18th June 2025, 09:30-12:00 Claire Rae presented the paper and advised IJB members that the Chair of the IJB should alternate between the voting representatives of North Lanarkshire Council and NHS Lanarkshire Board. Noted since 2022, the Chair has been nominated from North Lanarkshire Council from the cohort of elected members and from June 2025, the chair of the IJB will handover to NHS Lanarkshire Board for a three-year period until 2028. The rules around IJB membership applies to all members except for the Chief Officer, Financial Officer and the Chief Social Work Officer who remain on the Board as long as they hold their respective posts. Therefore, all members of the IJB require to be renewed in 2025. An established process is in place to seek nominations for stakeholder members. It is recommended that the IJB note and approve the contents of report: I. the handover of the IJB Chair from North Lanarkshire Council to NHS Lanarkshire Board from June 2025 II. the revised membership of the voting members of the IJB from June 2025 III. Approve the recommendations for Chair & Vice Chair of the Performance, Finance & Audit Committee (P, F&A). The IJB approve the contents of the paper. 17. Risk