03 - 2025-09-17 IJB - IJB Mintes 18 June 2025
North Lanarkshire Council · 17 September 2025
Back to Health and Social Care Integration Joint Board — 17 September 2025 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Page 1 of 11 ITEM: Integration Joint Board Performance Minutes from the meeting held on Wednesday 18th June 2025, 09.30 – 12.00 via MS Teams PRESENT Voting Members: Cllr Claire Barclay NLC Nominated Councillor Cllr Bob Burgess NLC Nominated Councillor Brian Moore (Chair) NHS Lanarkshire Nominated Non-Executive Siobhan White NHS Lanarkshire Nominated Non-Executive Others In Attendance: Graeme Cowan Mark Dell Communications manager Diane Fraser Head of Adult Social Care Alison Gordon Head of Children & Families & Justice Services CSWO of NLC Joanne Jenkins Nurse Director NL HSCP / Nurse Representative Louise Long Chief Executive Jocelyn Lyall Chief Internal Auditor Catherine McGinty Unison / Staff Side Representative (NHSL) Thomas Moan Senior Manager – Community Solutions VANL Ann Muir Chair of North Lanarkshire Disability Forum Lucy Munro Medical Director for Health & Social Care North Lanarkshire Des Murray Fiona Owens Josephine Pravinkumar Director of Public Health and Health Policy Claire Rae Chief Office NL HSCP Roslyn Rafferty Head of Strategy & Performance Harry Robertson North Lanarkshire Carers Together / Carer Representative Mark Russell *left 10.09 Medical Director (South Lanarkshire HSCP/Primary Care) Fiona Sanderson Lead Pharmacist - Primary Care Nicola Scott Chief Finance Officer Francis Scott Chief Officer (Audit and Risk) Tyra Smyth GP Sub Secretary Kerry Taylor Business Support Manager David Wood Chief Executive Officer with VANL Dawn Wright (Minutes) Management Team Secretary Apologies: Nauman Dar NHS Lanarkshire Nominated Non-Executive Cllr Paul Kelly NLC Nominated Councillor Cllr Anne McCrory NLC Nominated Councillor Phillip Couser NHS Lanarkshire Nominated Non-Executive Morag Dendy Head of Planning, Performance & Quality John Watson Employee Representative NLC Peter McCrossan Director for AHPs Jackie Jones Deputy Chief Executive and Director of Human Resources
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Page 2 of 11 1. Welcome and Apologies The chair welcomed everyone to the meeting and apologies were noted as above. The chair also acknowledged the 10th anniversary of the IJB's establishment. Brian Moore 2. Declaration of Interests No declarations of interest were made. All 3. Minutes IJB (19th March 2025) The minutes were approved as an accurate record. Brian Moore 4. Minutes IJB PFA (21st May 2025) The minutes were approved as an accurate record. Brian Moore 5. Matters Arising/ Rolling Action List No issues were raised regarding matters arising. Rolling Actions: 25 - Dates still to be arranged. 27 - Ongoing. 31 - Communications to be out by the end of June. 32 - Complete, as Lucy brought it back to the IJB PFA meeting. 33 - To be taken back to the next IJB PFA meeting. Brian Moore /Claire Rae 6. Chief Officer Update Claire Rae provided an update on recent activities and developments. Louise Long started as the new Chief Executive of NHS Lanarkshire on 5th May, with positive feedback from visits to CAMHS service and Holdsworth Centre. More visits are planned. The Care Reform Bill, formerly the National Care Service, passed on June 10. Key provisions include "Anne's Law" (upholding rights of care home residents to see loved ones), strengthened support for unpaid carers (right to breaks, improved access to independent advocacy), and the establishment of a national chief social work advisor role. The Advisory Board is set to replace the interim board in May. The Population Health Framework and the Health and Social Care Renewal Framework (both 10-year plans) were published yesterday, jointly developed by COSLA and the Scottish Government. A development session for IJB will be arranged to discuss these in more detail. The assistive tech team was shortlisted for the Local Government Chronicle Awards, acknowledging their nomination, though unfortunately they did not win. Claire Rae
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Page 3 of 11 Chief officers met with Minister Mary Todd to extensively discuss the IJB's financial challenges. The first meeting of this board occurred last month, with a vision session scheduled for tomorrow. This will be brought back to the IJB for a detailed discussion on priorities. Brian Moore queried the need to review existing practices or policies in light of new carers legislation and short breaks. Claire Rae confirmed this would be examined and reported back within the context of the carer strategy. Strategic Planning & Development 7. PCIP Update Mark Russell highlighted that the action plan focuses on concrete changes, not just strategy. He outlined key challenges in Lanarkshire’s primary care, especially North Lanarkshire, due to limited resources, GP shortages, and high deprivation, which worsen the "inverse care law." The PCAP expands primary care to include all community health services beyond GPs, dentists, optometrists, and pharmacists. Its goal is to streamline access pathways, currently muddled by over 60 self-referral options, leading residents to rely mainly on GPs or A&E. The action plan focuses on three areas: 1. Developing meaningful alternatives to general practice: This includes optimising existing services (e.g., Community Treatment and Care, Pharmacotherapy) and developing new ones, such as encouraging direct contact with physiotherapy teams for musculoskeletal problems, rather than GPs. 2. Reshaping care pathways: This aims to reduce workload on general practice by diverting work from secondary care directly to appropriate services. 3. Refocusing practice capacity: Providing assets and support (e.g., digital tools) to practices to facilitate change and innovation, with a focus on a "once for Lanarkshire" approach for impact assessments. A work stream is assessing the impact of these changes on patients and general practice, with a summer project with Strathclyde University to gather effectiveness data. Additionally, NES and local digital teams will provide free digital services and communication tools to all 93 Lanarkshire general practices over nine months, extending to key community services. DPI assessments will be managed by the Health Board to ensure safe adoption. Siobhan White asked about the risk to the board’s ability to provide General Medical Services. Mark Russell explained that this risk is decreasing due to better locum GP availability, but this is driven by practices reducing discretionary sessions for financial reasons, likely decreasing overall GP access for patients. Councillor Claire Barclay emphasised the need for public communication to raise awareness of alternative care options, as many default to GPs or A&E. Mark Russell confirmed a social media campaign launching this summer to inform the public about service changes and vowed to arrange a liaison session on the digital front door once procurement progresses. Mark Russell
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Page 4 of 11 Councillor Bob Burgess questioned the adequacy of musculoskeletal clinics in Cumbernauld. Mark Russell confirmed that Community Appointment Days rotate throughout Lanarkshire and are now being expanded to weekly sessions, becoming a regional staple, with councils facilitating access through facilities like sports centres. Brian Moore asked about the benefits derived from the Primary Care Improvement Plan (PCIP) funding and Pharmacy Plus initiatives, as well as the current status of the GP contract. Mark Russell acknowledged PCIP’s contribution but stated it’s insufficient for systemic change. Impact assessment with Strathclyde University is ongoing. Pharmacotherapy has improved outcomes, with medicines reconciliation now managed by hubs, freeing GP time. National talks on the GP contract continue. The Scottish Government is creating a primary care roadmap and business case. PCIP was Phase 1 and Phase 2, boards covering non-clinical costs has stalled due to funding shortages, parallel to capital investment issues for GP premises. RECOMMENDATIONS The IJB committee noted the progress of the Primary Care Action Plan (PCAP) as the overarching delivery framework for Primary Care transformation The IJB committee noted the rationale for investing in a digital access platform to support both general practice and community service accessibility. The IJB committee noted the steps taken to enhance impact measurement and quality assurance alongside the development of a unified key performance indicator framework 8. Public Health Annual Report Josephine Pravinkumar gave an overview of the Public Heath Annual Report which focuses on the health of children, young people, and infants this year. The report highlights achievements, challenges, and future priorities in public health, with a strong emphasis on prevention, early intervention, and addressing inequalities. The 10-year plan for the population health framework has been published, and there are plans for a joint session to review its outputs. North Lanarkshire is well-positioned, having already aligned its strategic priorities with the framework. The report specifically focused on children, young people, and infants, with significant contributions from children in North Lanarkshire who influenced the report with their pictures, drawings, and comments on health and well-being. This focus aligns with the UNCRC. Good progress has been made on actions related to the "anchor" theme from the previous year's report, including successes in employability. There is a joint venture across the system to support young people and specific communities in their employment journeys, with a signed Memorandum of Understanding and a community wealth building statement. Josephine Pravinkumar
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Page 5 of 11 Opportunities are being explored through the Monkland project to look at community benefits and support the wider community. Excellent progress has been made in oral health, and North Lanarkshire is leading in breastfeeding initiatives. The region is performing well in pregnancy and new-born screening programmes. A number of challenges remain in child health, which are not a surprise to the committee. Concerns exist about not meeting child poverty targets, and this remains a key focus area in the new population health framework. While digital and innovative solutions are being used to support mental health, more work is needed, especially concerning issues like young people resorting to vaping and smoking due to stress and lack of resilience. There is a continued concern about widening inequalities across all areas, and the population health framework is expected to provide an additional lever to address this. The high smoking rates in North Lanarkshire (third highest in the UK) are a real concern, and a national tobacco and vaping framework is being used to take action against these issues, including new forms of tobacco products like pouches. There are disparities in maternal and childhood vaccination uptake across localities. Councillor Bob Burgess noted that 33% of young children in North Lanarkshire are diagnosed with ASN. Josephine Pravinkumar was unaware of this figure but will investigate and respond. Early identification is vital, but the root causes must be examined. Siobhan White highlighted the persistent gender gap in life expectancy across Scotland, including North Lanarkshire. Josephine Pravinkumar attributed this to factors such as early neurodevelopmental issues, maternal and childhood obesity, and low birth weight, which contribute to chronic diseases. Preventive measures, early intervention, and tackling socioeconomic factors like child poverty are essential. Claire Rae emphasised a whole-system approach, including housing and economic determinants, to address the gap. Brian Moore asked about targeting low vaccination areas. Josephine Pravinkumar confirmed public health is identifying uptake disparities, reviewing services, partnering with community and faith groups, and using the Scottish Vaccination Immunisation Framework for targeted actions. Lower uptake in some areas and ethnic groups is linked to misinformation, requiring more resources. The population health framework and an inequalities action plan will support these efforts. A briefing on the population health framework will be organised in the future. RECOMMENDATIONS
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Page 6 of 11 The IJB committee noted the contents of the report in particular the key priorities that need actioned to improve children’s and the wider population health. 9. NHS Lanarkshire Board - 2025-26 Delivery Plan – Delivering Our Health Together Roslyn Rafferty presented the "Delivering Our Health Together" plan, which outlines local actions and timelines aligned with the Scottish Government and NHS Lanarkshire's transformation and reform priorities. The plan was developed based on prescribed Scottish Government guidance issued in December, emphasizing a shift from recovery to transformation and reform, encompassing 13 delivery areas and 80 planning priorities. It ensures alignment with local finance, workforce, and quality plans, integrates new National Health and Social Care reform ambitions (launched in January), and aims to optimise service delivery, workforce, and financial resources. The plan's development involved the corporate management team and senior leaders from January to March. It was initially shared in draft form with the board in February and with the EDG in March, before being submitted to the Scottish Government. Subsequent updates incorporated successful bids for operational improvement plan funding, leading to approval for submission to the board in mid-May. Joanne Jenkins discussed the health visitor workforce, noting a decline in registrants, particularly for learning disabilities. The health visitor role remains attractive, and efforts are underway to plan workforce needs by predicting retirements and ensuring sufficient posts for trainees, while adhering to budget constraints. A paper was recently approved by SMT, and the situation will be re-evaluated in October. RECOMMENDATIONS The IJB committee noted the contents of the report. Roslyn Rafferty 10. Lanarkshire Winter Plan Debrief Graeme Cowan provided a debrief on its implementation and to outline key learnings for the 2025/2026 winter plan. The plan, which started in August 2024 in line with national guidance, focused on four main priorities: 1. Prioritising community care to enable people to live at home and avoid hospital stays. 2. Ensuring individuals receive appropriate care responses, with an emphasis on home-based or close-to-home services. 3. Maximising capacity within the health, social care, and social work systems, protecting planned care, and reducing long waits. 4. Focusing on the well-being of the workforce and acknowledging the commitment of unpaid carers. The 2024 plan covered several areas, including: Graeme Cowan
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Page 7 of 11 Expansion of the Flow Navigation Centre Plus in 2024/2025, detailed in Appendix 1. This included new virtual wards, increased multidisciplinary staff (like MSK physios and Scottish Ambulance Service), and enhanced nursing staff availability during peak periods. The HSCP focused on supporting hospital discharges through a home assessment approach in North Lanarkshire. Work was undertaken to maintain relationships with commissioned providers to ensure their ability to respond throughout the winter. Over two-thirds of GP practices in Lanarkshire were open during some public holidays over Christmas and New Year. Enhancements were made to primary care out-of-hours services using multidisciplinary teams, allowing more signposting away from A&E. Despite national coordination for flu and COVID-19 vaccinations, local efforts included extended use of pop-up clinics and community pharmacy appointments. However, overall uptake rates for the general population and staff were down in 2024/2025. Continued support was provided through commissioned carer organizations and enhanced assistance for carers helping people return home from hospital during winter. Enhanced messaging and communications aimed to increase awareness of staff health and well-being platforms. The debrief identified several learning points to be progressed for the 2025/2026 winter plan: Addressing vaccination uptake rates, including staff vaccination. Working with managers to minimise leave allocation during winter to ensure sufficient staff availability. Further learning points on operational flow and the Flow Navigation Centre are in Appendix 1. Continuing the "discharge without delay" approach, focusing on assessing people at home rather than in hospital. Moving into 2025/2026, the responsibility for winter planning will transfer from the South Lanarkshire-led group to NHS Lanarkshire's Planning Directorate. The IJB will be kept informed of future plans. Councillor Bob Burgess questioned who determines if a discharge package is adequate, citing issues like alarms and ramps. Graeme Cowan replied that it depends on the patient's circumstances, involving relevant professionals or a single coordinator to assess support needs and family input, and offered to review specific cases privately. Brian Moore asked if a different approach to staff vaccinations is needed due to declining uptake. Josephine Pravinkumar explained that targeted efforts, including peer support and vaccinators, are in place, with an action plan presented to the Population Health Committee. Claire Rae added that collaboration with the quality department involves safety cards to assess risks for staff and patients. A review of vaccination services, focusing on areas with low uptake, is ongoing, with a report due by September.
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Page 8 of 11 Brian Moore inquired about managing annual leave during peak times. Claire Rae confirmed existing targets and quotas across health and social care, managed within agreed parameters. She noted unplanned leave, like sickness, can affect this, especially at Christmas, but policies are established to address it. Brian Moore thanked Graeme Cowan for the report, noting that winter planning is now recognised as a year-round process and that learnings from the past winter have been identified. RECOMMENDATIONS The IJB committee noted the contents of the report. Performance & Finance 11. Unaudited North Lanarkshire IJB Annual Accounts 2024/2025 Nicola Scott presented the unaudited North Lanarkshire IJB annual accounts for 2024/25 for approval. Siobhan White asked about narrative categories in the income and expenditure statement. Nicola Scott said detailed breakdowns aren't required unless needed, noting external audits favour shorter, less operational accounts. She will discuss with Audit Scotland the option of adding a glossary for clarity. Siobhan White noted the different format of the balance sheet. Nicola Scott explained it's simpler because the IJB doesn't hold assets. Siobhan White asked about declarations regarding fraud, bribery, and corruption. Nicola Scott stated this would be part of the audit report, and the only required declaration from the IJB is within the statement of responsibilities on page 19. Brian Moore and Josephine Pravinkumar emphasised prioritising prevention and early intervention within the new population health framework, recognising challenges in measuring impact and budgeting, and anticipating national efforts to guide future strategies. Siobhan White asked about new accounting standards like IES 1 affecting account presentation. Nicola Scott is aware of meetings on this and will confirm the timeline. RECOMMENDATIONS The IJB committee approved the Annual Governance Statement and associated reports for inclusion in the statutory accounts. The IJB committee approved the unaudited North Lanarkshire IJB Annual Accounts 2024/25 at Appendix 1. The IJB committee approved the submission of the unaudited annual accounts to Audit Scotland. The IJB committee acknowledged the arrangements for publication of the North Lanarkshire IJB Annual Accounts 2024/25 in line with the legislative requirements. Nicola Scott 12. IJB Annual Performance Report Graeme Cowan explained that the IJB Annual Performance Report is required to be published by the end of July according to statutory regulations in the Public Bodies Act. Graeme Cowan
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Page 9 of 11 However, a significant constraint in meeting this deadline is the availability of national indicator data, which is not finalised until early July. To address this, the board were asked to approve the below recommendations. RECOMMENDATIONS The IJB committee agreed to delegate authority to the Chief Officer of North Lanarkshire HSCP to publish the draft version of the Annual Performance Report on the HSCP website by 31 July 2025. The IJB committee agreed to receive the finalised report at the next IJB meeting in September 2025 for approval. Governance & Policy 13. IJB Governance Overview Report Kerry Taylor presented the IJB governance overview report, detailing recent reviews of governance documents and reporting arrangements to ensure compliance with the Public Bodies Joint Working Act. The report encompasses the Code of Conduct, declaration of interests, board's directions, records management plan, standing orders, terms of reference, role descriptions, induction process for members, integration scheme, Annual Governance Statement, scheme of delegations, and membership updates. Due to a prolonged staff vacancy, there has been a delay in issuing declaration of interest forms to members. These forms will be issued following today's meeting. Brian Moore asked about standing order review. Kerry Taylor said it’s due for a three- year review but will likely be revisited early next year after other governance matters. It may be discussed at a development session before being presented to the IJB PFA or the full board, with the IJB PFA the probable first step. Brian Moore inquired about the record management plan timeline. Kerry Taylor confirmed National Records Scotland usually requests an update in August during the annual review. North Lanarkshire Council is reviewing it, with a target to present for approval at the September board meeting before submission. RECOMMENDATIONS The IJB committee agreed to review the updated IJB Governance Report. The IJB committee noted that the Code of Conduct and Declaration of Interest Forms will be issued to IJB members for completion for 2025- 2026. The IJB committee noted that the Records Management Plan will be presented to a future Board meeting. The IJB committee approved a review of the Standing Orders. The IJB committee approved a review of the roles and responsibilities for Board members alongside a new induction process. The IJB committee approved the development of North Lanarkshire IJB’s Scheme of Delegations. Kerry Taylor 14. Self-Assessment Questionnaire
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Page 10 of 11 The questionnaire will be distributed electronically next week and remain open until the end of August to allow members appropriate time to complete it, considering the summer holiday period. RECOMMENDATIONS The IJB committee considered carrying out a self-assessment of the Board’s effectiveness by the use of the questionnaire. The IJB committee approved the draft questionnaire at Appendix 1. The IJB committee approved the questionnaire being issued to Board members and the results reported to a future meeting. Kerry Taylor 15. Support Care and Clinical Governance Update The Bi-Monthly Support Care and Clinical Governance Update reports to the IJB, with discussions on quarterly meetings, but bi-monthly due to workload, aligned with other regions. It reports to the Healthcare Governance and Assurance Committees and aims to inform adult social care and social work structures. Key updates include enhanced governance in social work and social care, led by Diane Fraser, following Scottish Government guidance. In healthcare, focus has been on adverse events, themes, and quality improvement. The group’s chair ship is rotational; Lucy Munro has chaired for over 1.5 years, with her term extended to 2.5 years. Diane Fraser will take over as chair in April, with Joanne Jenkins as Vice Chair. Appendices require updating; Kerry Taylor will review them. The report remains high-level, confirming assurance without unnecessary duplication. Brian Moore shared that he found the report too high-level and lacked detail on key issues and SAERs related to the HSCP. He noted that while annual reports go to the healthcare committee, the IJB often doesn't receive papers on specific areas like learning disabilities or addictions, despite assurance statements. Brian Moore questioned whether stating "everything's OK" sufficed, emphasising the need for more concrete evidence to truly assure the IJB. Lucy Munro acknowledged Brian's concerns, explaining that reports are prepared for multiple committees, and the delegation scheme requires each organisation to manage its own affairs, making it difficult to determine the appropriate level of detail for the IJB. She offered to provide more detailed reports or discuss further in a separate session. Claire Rae said the issue was raised pre-agenda and will be addressed by SMT. She recommended summarising joint reports from governance groups for each partner and presenting them to the IJB—frequency to be decided—to highlight common SAER themes. Brian Moore stressed balancing detail to avoid overload, ensuring the IJB is informed of issues and can learn from them. RECOMMENDATIONS The IJB committee noted the update from the Support Care and Clinical Governance committee. Lucy Munro For Noting 16. Risk
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Page 11 of 11 None raised 17. Date of next IJB meeting: 17th September 2025, 9.30am –12pm, Via MS Teams