Item 3 - Minute of Meeting of the IJB Held on 30 November 2022
North Lanarkshire Council · 22 March 2023
Back to Health and Social Care Integration Joint Board — 22 March 2023 and its agenda
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1 ITEM 3 Integration Joint Board Committee Minutes from a meeting held on Microsoft Teams on Wednesday 30th November 2022 at 2pm-4pm Present: Voting Members: Ally Boyle NHS Lanarkshire Nominated Non Exec Director Councillor Gerry Brennan North Lanarkshire Nominated Councillor Councillor Paul Kelly North Lanarkshire Council Nominated Councillor Councillor Ayeshah Khan (Chair) North Lanarkshire Council Nominated Councillor Brian Moore NHS Lanarkshire Nominated Non Exec Director James Muir 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 Cathy McGinty Staff Side Representative NHSL Elizabeth Seaton Partnership for Change User Rep Harry Robertson Carer Representative John Watson Employee Representative NLC Unison Officer in Attendance: Stacey Connor Minute Secretary Mark Dell Communications Manager Morag Dendy Head of Planning, Performance & Quality Diane Fraser Head of Adult Social Work Services Alison Gordon Head of Children & Families & Justice Services CSWO of NLC Maddie Halliday Chief Exec, VANL Third Sector Rep Trudi Marshall Nurse Director NLHSCP Gillian McCreadie Audit Scotland Marie McFadden Audit Scotland Dr Lucy Munro Medical Director NL Des Murray Chief Executive NLC Dr Tyra Smyth General Practitioner (GP) Maggs Thomson Head of Health North HSCP APOLOGIES: Councillor Bob Burgess North Lanarkshire Council Nominated Councillor
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2 Dr Kenneth Dagg Secondary Care Medical Practitioner 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 21.9.22 The previous minutes were approved as an accurate reflection of the discussion. 4. Matters Arising/ IJB Action Log There were no matters arising. Ross McGuffie shared an updated action log to reflect the progression of work since the last committee. The following updates were noted by the committee: Item 1 Reserve Strategy- This will be brought to March 2023 committee to align with SCP. Item 4 Addictions Services- Ongoing updates on progress scheduled into forward plan for PFA. Item 5 Category One Responders - Self assessment completed and feedback from West of Scotland Regional Resilience Partnership received. Update report to next IJB in March 23. 5. External Auditor Annual Audit Report This report:- 1. Outlines the outcome of the audit by the North Lanarkshire Integration Joint Board’s External Auditor, Audit Scotland: 2. Advises that the External Auditor has submitted an Annual Audit Report setting out their key findings for the consideration of the members of the Integration Joint Board (IJB); and 3. Provides details of the proposed management response to the action points detailed in the External Auditor’s Annual Audit Report.
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3 The External Auditor’s Annual Audit Report on the IJB Annual Accounts extend across several subjects- IJB Annual Accounts 2021/2022, Financial management and sustainability; and Governance, transparency, and best value. The External Auditor has concluded that the financial statements of the North Lanarkshire IJB for 2021/2022 give a true and fair view of the net expenditure of the year and have therefore issued an unqualified independent report. The report includes the key messages and an action plan on pages 20 to 21 which have been agreed by both the Chief Officer and the Chief Finance Officer. The External Auditor highlighted that there are no significant findings to report the North Lanarkshire IJB Annual Accounts 2021/2022 and no misstatements were identified. Marie McFadden drew the committee’s attention to page 29 within the report. A draft letter of representation has been provided within the report which will be signed prior to report being issued. The recommendations made within the report are as follows: 1) The notice of inspection should state the objection end date and the advert should be posted on the IJB website in addition to the North Lanarkshire Council website. 2) The IJB should develop a reserves strategy for 2022/23 which sets out how and when monies will be spent. 3) The financial regulations should be reviewed to ensure they remain up-to-date and fit for purpose. The chair, Amanda Kilburn and Ross McGuffie are invited to sign off the documents after the committee. Marie McFadden asked the committee to their knowledge is there any suspected fraud activity; members were invited to make contact to advise if this was the case. The committee had no questions. The IJB agreed the following recommendations: (1) Consider the External Auditor’s Annual Audit Report, attached at appendix 2, in advance of the approval of the IJB Annual Accounts 2021/2022; (2) Note that an unqualified audit certificate has been received in respect of the North Lanarkshire IJB Annual Accounts 2021/2022; and (3) Approve the management response to the action points which is highlighted at pages 20 to 21 of the External Auditor’s Annual Audit Report, attached at appendix 2.
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4 6. Audited IJB Annual Accounts The report tabled provides details of the unsigned audited IJB Annual Accounts 2021/2022 for consideration and approval by the IJB. The IJB Annual Accounts 2021/2022 were prepared in accordance with the requirements of the Local Government (Scotland) Act 1973 and the Local Government in Scotland Act 2003. This means that suitable accounting policies were selected and applied consistently, reasonable, and prudent judgement were made, and proper accounting records were maintained. The preparation of the unaudited annual accounts also met the statutory deadline of 30 June 2022. The External Auditor has concluded that the financial statements of the North Lanarkshire IJB for 2021/2022 give a true and fair of its net expenditure for the year and have therefore issued an unqualified independent auditor’s report. The findings of the audit process have also been reported to the IJB and an action plan approved as set out in the External Auditor’s Annual Audit Report. Maddy Halliday noted the uplift in income is less than the inflation rate. Also it would be good to have wider stakeholder engagement when the website is refreshed; this was noted. Brian Moore asked on p11 of the report in terms of learning from covid has a review been undertaken. Ross McGuffie advised this has been reviewed as part of the SCP engagement work. The IJB agreed the following recommendations: (1) Note that the External Auditor’s audit opinions are all unqualified in respect of the IJB Annual Accounts 2021/2022; (2) Approve the IJB Annual Accounts 2021/2022 for signature; and (3) Note that the signed audited IJB Annual Accounts 2021/2022 will be available to view electronically at the following website: https://www.hscnorthlan.scot/key-documents/ 7. Financial Monitoring The report provides a summary of the financial position of the North Lanarkshire Health and Social Care Partnership (HSCP) for the period from 1 April 2022 to 30 September 2022 (Health Care Services) and 1 April 2022 to 14 October 2022 (Social Work and Housing Services). The financial position as at September 2022 is summarised as follows: there is a net underspend of £3.838m on the core budgets within Health Care Services
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5 there is a net underspend of £3.820m on the core budgets within Social Care and Housing Services The total underspend represents approximately 1.1% of the total financial envelope available. There is a net underspend of £1.182m. The net underspend on pay costs totals £1.598m and is mainly due to vacancies across Nursing Services and Administration and Clerical staff within the localities totalling 62.46 FTE. There are incremental pay increases and unfunded enhancements across many services however these cost pressures are being offset in-year by the vacancies. In respect of non-pay costs, there is a net overspend totalling £0.416m. The overspend is mainly due to payments in respect of Strathcarron Hospice (£0.285m). This cost is being managed on a non-recurring basis. A recurring funding solution requires to be identified. The Covid-19 pandemic has created significant financial management and financial planning challenges for both partners and the IJB. These challenges have centred around the difficulties in predicting the costs associated with the recovery from the Covid-19 pandemic. The 2022/2023 Covid-19 costs are being reported to the Scottish Government through the Lanarkshire Finance Performance Return on a monthly basis. There continues to be a significant degree of uncertainty in respect of the financial implications of the Covid-19 pandemic however the Scottish Government have advised IJBs that they will reclaim surplus Covid-19 reserves to be redistributed across the sector to meet current Covid-19 priorities. There is ongoing dialogue with the Scottish Government in respect of this potential reclaim. Cllr Kelly asked for clarity on Scottish Government timescales around claiming back covid 19 reserve and is there any other intelligence from other IJBs. Amanda Kilburn advised there has been no indication when this will happen and what the amount will be, although data has been submitted for period 6 and 7. This is a standing agenda item on the CFO national group; other boards are in the same position. Ross McGuffie noted have submitted projections for spend in year which will be protected and will look at any surplus to redirect into the wider system. So any claw back will be based on this. The challenge is when funding is in reserves can only spend on delegated services. The committee noted the points raised and will consider if an additional meeting is required when clarity is issued from Scottish Government. Des Murray proposed the committee may wish to seek legal advice regarding the situation also.
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6 Brian Moore noted nationally there is a high profile on agency staff, it would be useful to get figures in relation to the spend on this area within Lanarkshire. Ross McGuffie noted this can be included in future reports, there are governance process in place before agency staff are used and require senior management approval. The IJB noted the following recommendations: Note the contents of the report; and Note that the financial position in September is an underspend of £7.658m (NHSL - £3.838m; NLC - £3.820m). This excludes the impact of further recruitment challenges and staff turnover and any potential new Scottish Government funding. 8. Covid Update As at 18th November, the seven-day case rate within North Lanarkshire is 35.2 per 100k population, which is a small decrease to the figures last presented to the IJB PFA from 31st October when it was 49.8 per 100k. As of today got 66 covid positive inpatients, 7 care home outbreaks covering staff and residents- to note care home outbreaks usually indicate increase in community transmissions. Delayed discharges been sitting in 80s/90s there has been an increase in volume of referrals for supported discharge which has been challenging. Had number of delay in moves to care home but this has improved. Currently got 21 complex applications in the system, challenge with these case if there is a guardianship application can take up to 13 weeks to be completed. Adults with Incapacity (AWIs) make up half delayed discharge patients. The Mental Welfare Commission (MWC) and Scottish Government have issued new guidance on AWIs, hoping this change in legislation will aid individuals to move quicker through the acute system. Ross McGuffie advised there was a whole system planning session held on 24th November which include the health board, South HSCP and North HSCP colleagues. An action plan has been agreed to be completed by the end of the year. 1.8m covid vaccine doses have been provided to date, still not as high as anticipated which has been an issue nationally. Promoting communication and clinics to encourage uptake. The inpatient peak of the second wave of Omicron was 322 covid positive inpatients on 28th March 2022, with a further 63 in off-site facilities. As at 18th November, there are 53 covid positive inpatients and a further 3 in offsite facilities, which in total is a decrease of 24 compared to the position on 31st October.
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7 Cllr Kelly noted tribute to staff across the partnership supporting patients to get back to the community. Ross McGuffie will pass this on. Cllr Kelly also asked can we cope with covid currently levels and have we looked at projection of potential staff absence levels. Also what has been the impact of flu this year. Ross McGuffie acknowledged it is challenging to predict absence levels, Public Health’s view is seeing a rise in younger age groups but the school holidays will aid a break. Although acknowledge that things can change quickly if any new variants become apparent. More concern around flu cases this year, acute sector is running at capacity currently so it would be a concern if there was a great increase in demand. Dr Lucy Munro noted flu numbers are above baseline and they are being monitored due to impact in Southern hemisphere. The IJB noted: (1) Progress made during the pandemic response (2) Request that future updates move to focus on recovery and remobilisation, unless the command structure is reinstated due to further significant waves. 9. Quality Assurance The report highlights Quality Assurance activity over the period 1 April 21 to 31 March 22 and covers Contracts & Contract Management, Regulatory Activity, Procurement, Complaints, Duty of Candour, Provider Sustainability and Children & Families. Key part of the work are outlined below: Contracts - In partnership with colleagues from Corporate Procurement, the Quality Assurance Team is responsible for procuring and contracting with a wide variety of independent sector organisations who provide services to the most vulnerable people living in our communities. A methodical and systematic approach has been developed resulting in over 90% of services purchased by social work now having an agreement in place ranging from national framework arrangements to individual service agreements. Contract Management - A key function of the Quality Assurance Team is to ensure and evidence that effective, rigorous and consistent contract monitoring processes are in place with organisations from whom social work purchase services. This is to provide good quality and up to date information which will inform practice and strategic decision making in relation to the commissioning, contracting and compliance arrangements in place. The Monitoring Prioritisation Assessment (MPA) is the key component of the CMF. The MPA is the up-to-date position statement on the performance of commissioned contractors. The MPA determines the monitoring status of each commissioned service based on a tier system which consequently determines the frequency of monitoring activity. The tiers range from Tier 1 (green) which relates to satisfactory performance and a monitoring
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8 frequency of annually, in most cases, to Tier 4 (red) which indicates significant concerns in relation to service delivery and a monitoring frequency of 1 to 4 weekly. Regulatory Activity - During the COVID 19 pandemic, Care Inspection activity was focused around one key quality question “How good is our care and support during the Covid 19 pandemic?”. In late 2021, the focus slightly changed to include the quality question “How well do we support people's wellbeing?”. The inspections were predominately with Care Homes; however, a few Self-Directed Support providers were also inspected generally in response to complaints or increased notification activity to the Care Inspectorate. Provider sustainability - Since the start of the pandemic there have been ‘sustainability’ arrangements in place to ensure Social Care services/facilities continued to operate in a financially secure and viable manner including provision of payments when services couldn’t be delivered. The sustainability principles were due to end in June 2021 but further extensions have been applied. There remains a requirement to ensure that Social Care capacity is sustained to achieve positive outcomes for clients, whilst also addressing the overarching need to demonstrate value for money, streamline payment arrangements and demonstrate the approach is fair, equitable and transparent. Procurement - A fundamental aspect of the role of Quality Assurance is ensuring that the people North Lanarkshire Council (NLC) arranges support for can be confident that support is provided legally, safely, with their interests at the centre and that ensures Best Value for NLC. A key component of this work is carried out with our colleagues in Corporate Procurement. The collaboration with Corporate Procurement has enabled us to jointly pursue further refinements to commissioning and procurement. Children, Families and Justice - Quality Assurance monitors most Children’s services where a contract status has been secured either on an Individual Placement basis or as part of a Framework Agreement, generally through Scotland Excel. Complaints - Quality Assurance retains an overview role in terms of complaints made about NLC Social Work service provision. Regular quarterly reports on complaints activity are reported through our governance structures. Maddy Halliday noted complaints are included in the paper is there any scope to include user satisfaction and feedback in future. Also may be an opportunity to link with community solutions. Morag Dendy noted in refresh of SCP will be inclusive of this information. Brian Moore noted the report focuses on council contact processes, should reflect integration arrangements around duty of candour. Morag Dendy
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9 noted did meet colleagues in NHS procurement, information will be included in future reports in a more reflective way. Trudi Marshall noted there is a whole remit of work which could also be included in this. Cllr Brennan noted complaints received within the report are relatively low. Need to work on duty of candour issues as note no family wanted to be involved in reflective process. Morag Dendy acknowledge the team have considered different ways of involving families in the process and were assured they were supported exhaustively. The Committee endorsed the contents of the report. 10. Risk Register The purpose of this report is to provide a summary to the Integration Joint Board (IJB) on risk management activity, noting any amendments or additions to the current risk register. Four new risks were added to the IJB Risk Register and agreed at the September meeting of the IJB: IJB 15/22 – Cost of Living impacts IJB 16/22 – National Care Service IJB 17/22 – Unscheduled Care and patient flows IJB 18/22 – Community Alarms There are currently three risks rated as Very High on the IJB risk register. IJB 08/21 – Financial Implications of Responding to Covid IJB 09/21 – Impact on the Strategic Plan due to Covid IJB 17/22 – Unscheduled care and patient flows These risks were reviewed on 2nd November 2022 and will be subject to further review with the new Chief Finance Officer as part of the financial planning exercise for 2022/23. There are seven high rated risks on the IJB risk register. IJB 01/21 - Financial Challenges IJB 04/21 - Notional Set Aside Budget IJB 13/21 - Impact on discharge performance linked to care homes. IJB 12/21 - Staff Health & wellbeing IJB 14/22 - CAMHS IJB 15/22 – Cost of Living The IJB noted 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 Heath & Social Care North Lanarkshire partnership that impact upon delivery of IJB business.
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10 Ross McGuffie noted CAMHS and Staff Health Well-being risks have been updated after discussion at PFA. The risk sharing form is being updated to be used across the 2 partner organisations, adapting to include council risk as part of updated policy; planned to bring to March IJB. Maddy Halliday queried for the cost of living risk should this be rated very high risk as opposite to just high; particularly around the impact on staff. Ross McGuffie noted in terms of organisation risk this is being picked up on the finance risk register also but will continue to review and see what other mitigating measures need to be in place to manage the risk. Cllr Brenan noted in relation to community alarms why is the risk rated as high and how many workers do we have in the service. Ross McGuffie noted high risk is due to digital change over. At PFA approved on going procurement of devices to mitigate changes and working closely with providers. As part of winter business case looking to expand staff within the service. 11. Whistleblowing Annual Report The National Whistleblowing Standards and Once for Scotland whistleblowing policy (the Standards) were introduced on 1 April 2021. The Standards are applicable across all NHS services. This means that they must be accessible to anyone working to deliver an NHS service, whether directly or indirectly. It is a requirement of the Standards to formally and routinely report whistleblowing performance to NHS Boards, including the preparation of an annual report. The NHS Lanarkshire Whistleblowing Annual Report for 2021/20 was presented to the NHS Lanarkshire Board at its meeting of 31st August 2022. At that meeting the NHS Board confirmed that it had received assurance that whistleblowing standards are being followed and learning shared. Lesley McDonald noted all concerns raised last year related to acute hospitals.; for those concerns partially upheld it has led to staff improvements. The Integration Joint Board: 1) note the NHS Lanarkshire Whistleblowing Annual Report for 2021/20; and 2) note the assurance received by the NHS Lanarkshire Board that whistleblowing standards are being followed and learning shared. 12. Strategic Commissioning Plan The paper provides the draft Strategic Commissioning Plan for 2023-2026, developed through engagement and participation of a wide range of stakeholders. The draft plan will be subject to further consultation in January and February 2023 before final approval in March 2023.
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11 Health and Social Care North Lanarkshire has held extensive engagement in the development of the draft Strategic Commissioning Plan 2023-26. The draft plan will be subject to further consultation in January and February 2023 before seeking final approval in March 2023. A number of events have taken place to facilitate discussion in localities as well as targeted groups, Community Board members, elected member and IJB members, Strategic Planning Group and Staff Roadshows. The intention is that the draft plan is published and widely distributed for final public consultation on the content. Consultation will include the development of an animation to increase accessibility of the content and an on-line survey. Along with seeking comments on the draft plan a revised Programme of Work will be developed in early 2023. The Programme of Work will set out in detail the key work programmes that will be undertaken over the three- year period to meet the key ambitions set out in the Strategic Commissioning Plan. This will include detail of the aims of each work programme, anticipated performance impact, key deliverables, routes through committee and financial implications. There are 5 priorities and ambitions within the draft plan: Do the right thing first time Increased focus on prevention, early intervention and tackling inequalities by working with communities and people Develop and support a workforce for the future Improve mental health and wellbeing Support people through a whole family approach Cllr Brennan asked how does links with the housing department work in practical terms in relation to delayed discharges. Particularly to look at areas where there is capacity in the system to aid the discharge processes. Morag Dendy noted it links to the housing strategy as part of the SCP to work together which is integral to the plan. The programme of work will better demonstrate the details and housing colleagues are part of local planning groups and part of Planned Date of Discharge (PDD) meetings too. Going forward can consider how best to evidence this support. Brian Moore drew attention to the strategic needs assessment, how do we use this information to be more targeted to local intelligence to those in need of more resources. Morag Dendy noted this is considered as part of local planning groups. Maddy Halliday noted the report would benefit by being more upfront to show links to whole system. Morag Dendy noted this is 1st draft so some of the language will be refined further as we get closer to a final report.
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12 The IJB: (1) Note progress on the completion of the Strategic Commissioning Plan 2023 – 2026. (2) Approve the draft version of the Strategic Commissioning Plan 2023 – 2026 for final consultation in early 2023. (3) Note that the final draft version of the plan will be presented to the IJB at its meeting in March 2023 for final approval. 13. MH HB CCC Beds At present, NHS Lanarkshire has two contracts for the provision of HBCCC beds, which were originally established in the early 1990’s. These contracts were originally devised to assist in the transition from centralised facilities in Hartwood Hospital and other older outlying facilities such as Cleland Hospital to more modern community placements throughout Lanarkshire. The contracts relate to: Cumbernauld £2,021,180 per annum originally for 60 beds, now reconfigured to 52 beds. Hattonlea Care Home in Bellshill which is operated by HC-One at an annual cost of £3,138,067 per annum originally for 90 beds, now reconfigured to 75 beds. The total cost of both contracts is £5,159,247. Both contracts have a 12- month notice period. Based on this falling demand, the NHS Board and IJBs agreed in March 2020 that a business case be developed for the consolidation of contracted HBCCC provision onto the site at Hatton Lea, providing an enhanced pan- Lanarkshire service within the existing terms and conditions of the contract with HC-One. However, due to the impact of the pandemic, the planned work was delayed as it was not possible to undertake any consultation work within the Care Home environment due to the risk of Covid-19 spread. Work commenced again at the end of 2021. An Engagement Planning Group was established with patient and carer representatives and staff to work through an options appraisal process to ensure that all options were identified, to test the original proposal against these and carry out an Equalities Impact Assessment. Following the national change in definition of HBCCC, demand for Mental Health Continuing Care has continued to decrease, resulting in reducing occupancy levels in the contracted beds in Cumbernauld Care Home and Hatton Lea. The IJB is asked to approve the attached business case for the consolidation of contracted HBCCC inpatient provision service onto one site for both North
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13 and South Lanarkshire residents, subject to endorsement by South Lanarkshire Integration Joint Board and Lanarkshire NHS Board. Once final approval is reached will begin engagement with provides to start the changes. Looking a reinvesting to expand MDT as part of the cost saving exercise to enhance care on offer, any saving will be split 51/41 across South IJB. Maddy Halliday queried for residents in Hattonlea are they fully funded. Ross McGuffie confirmed this is fully funded NHS care in a specialist unit. The IJB agreed the bellow recommendations: 1) Approve the attached business to consolidate the provision of Hospital Based Complex Clinical Care for old age psychiatry patients at Hatton Lea Care Home, providing a pan-Lanarkshire service within the existing terms and conditions of the contract with HC-One. 2) Approve the termination of the existing contract with Four Seasons for HBCCC beds at Cumbernauld Care Home. 3) Approve the use of a proportion of the savings achieved to establish an enhanced multi-disciplinary staffing model at Hatton Lea 14. Supporting Unpaid Carers This report is intended to provide an update the support in place for unpaid Carers across our communities and to seek endorsement of our approach to ensure continuation of support. We recognise that unpaid Carers of all ages play a vital role in the lives of the people they care for and the Council is committed to supporting Carers to ensure they can continue to provide that care for as long as they wish. The Carer Breather pilot over a period of 18 months is due to end in March 23. Early feedback on the success of the pilot has been very positive, particularly from those who were able to have a break together and for those providing care but who did not necessarily wish to identify with a carer’s organisation. Liz Seaton noted some of the stories at carers together are harrowing due to cost of living pressures, so it is well received to see this report outlining support offered. Cllr Kelly noted some of the issues are out with carers control so this will need to become more of national issue to offer the support required. Maddy Halliday if unpaid carers can’t continue to provide support formal system will have additional pressures leading to them struggling to manage. So this work forms a foundation for early prevention and intervention work.
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14 Cllr Brennan asked how we identify unpaid carers prior to a patient discharge is there a support plan put in place. Mora Dendy noted doing a lot work in communities so there is an opportunity for those who don’t automatically identify as a carer to still be supported. Currently involve important family member as part of the discharge process. The IJB committee note: a) The content of the Report is noted b) Our approach to supporting unpaid Carers is endorsed. c) Note the request to extend service contracts is endorsed to ensure a continuation of support is available for unpaid Carers. 15. Net Zero The purpose of this report is to provide a summary to the Integration Joint Board (IJB) on Climate Change reporting requirements and seek approval for submission of the annual Climate Change report to the Scottish Government. The IJB is also asked to note correspondence from Michael Mathieson, Cabinet Secretary for Net Zero, Energy and Transport, highlighting a strengthening in Climate Change reporting requirements for public bodies. Mandatory reporting legislation in relation to Climate Change came into force in 2015 with the IJB, as a public body, required to report annually on compliance with climate change duties. The relevant legislation is the Climate Change (Duties of Public Bodies; Reporting Requirements) (Scotland) 2015 and the associated amendment order of 2020. North Lanarkshire IJB has complied in full with reporting requirements since the enactment of the legislation. Further guidance specific to IJBs was issued by the Scottish Government Domestic Climate Change Division for the 2021-2022 reporting period. This guidance relates to areas that NL IJB already reported on, including the structure of the IJB and its links to the bodies it is in partnership with. There is also a requirement to report on Greenhouse gasses and other emissions, where possible, and as requested, links have been made to the reports to be submitted by North Lanarkshire Council and NHS Lanarkshire, the bodies with responsibilities in these areas. Maddy Halliday noted could support a partnership initiative going forward; this was noted. The IJB is agreed the contents of the Climate Change report prior to its submission. 16. Cost of Living Helpline Report Given the severity of the current cost of living crisis resilience arrangements were however stood up by the Council to support planning of further
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15 mitigating measures with partners. The detail of these is reflected in the second report provided at section 7 as a background paper, ‘Cost of Living Response’ In view of the likelihood that the current cost of living crisis will exacerbate existing health inequalities through its wider impacts on physical and mental health and well-being and its strong commitment to prevention, the Health and Social Care Partnership have been keen to explore options to enhance the early help and advice available to individuals and families impacted by the current crisis, identifying this as a potential priority which could be supported, if agreed , through current reserves. In particular, the partnership has considered the potential to fund and promote a ‘helpline’ resource. The funding required is £300,000, each year over two years 23/24 and 24/25 (£600,000 in total) which will allow the Tackling Poverty Team to recruit staff as soon as possible. This will provide additional support to the Lanarkshire population. It would be the intention to report back to the IJB Board under the same cycle of reporting back to the Council’s Wellbeing and Tackling Poverty Committee, with the first update due in February 2023. Cllr Kelly noted the cost of living covers all aspects for people, need to ensure individuals running the helpline have information and resources available that are required. Also how will the service be promoted. Ross McGuffie advised have press release ready to go if the business case is approved. As part of this process working with the team to ensure there is wrap around support to look at where people are being sign posted to and to look at having the right supports in place. Maddy Halliday noted VANL have been liaising with council colleagues to advise of services available from them. Dr Lucy Munro noted Vicki Trim within the Health Improvement team is doing further tests of change with community nursing and linking with our AHPs regards routine enquiry. Brian Moore noted would be seeking regular updates from the work and would like to be clear where the funding is coming from as an audit trail. Ross McGuffie noted this will be included in the reserve strategy at year end. The IJB agreed the following recommendations: 1) Approve the proposal for the Helpline; and 2) Approve the funding request for the enhancement of the Tackling Poverty Team. 17. Winter Plan Planning for Winter 2022/23 commenced in July 2022 and, as in previous years, is undertaken in accordance with national guidance. The Lanarkshire
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16 approach to winter planning is a multi-agency approach across NHS Lanarkshire, North and South Lanarkshire Integration Joint Boards (IJBs) and both Councils together with the respective supports (for example, the Scottish Ambulance Service and NHS 24). On 04 October 2022, Scottish Government published a Winter Resilience Overview 2022-23 which set out the actions they are taking in an effort to support the sector over the winter period. That guidance set out the national expectations for those areas that local winter plans would be expected to address. As will be clear from the body of this report most of the areas identified already feature as part of the Lanarkshire winter planning process; are being reviewed/refined to ensure that they are as up to date as can be and resourced appropriately given available capacity. The guidance was further reinforced by subsequent correspondence to Chief Executives and Chief Officers on 12 October 2022 and 17 October 2022, the latter including a checklist for completion. Following a national event on 19 October 2022, further guidance was issued and an associated operational self-assessment on winter preparedness was issued. The submission made by the 7 November 2022 deadline reflected the content of this report. Discussion is still ongoing at national and local level on available funding to manage the impact of Covid 19 and ongoing pressures associated with both unscheduled and planned care. Work is ongoing between the NHS Lanarkshire Director of Finance, the two Chief Financial Officers of the IJBs and Council Finance Directors to be clear of those monies which have already been committed to meet ongoing service pressures/respond to previous Government policy; and that which may be available to support any new proposals. Ross McGuffie brought attention to discharge without delay work being reviewed ahead of the festive period. Looking to create some additional capacity in the system based on learning from frailty unit in Monklands. Part of this includes looking to identify wards with highest levels of falls. Looking to increase community capacity as much as possible too. Adverse weather is looking an increased risk, getting access to 4x4 and joined up visits are being planned. Supporting patients to access rights service via communications to save pressure at front doors. Cllr Kelly noted majority of patients go into to hospital and are discharged without delays. Also around staff well-being are we linking to cost of living work particularly around fuel costs etc. Ross McGuffie noted staff communication has included information on supports available. Brian Moore queried for interim beds are care homes still not interested in engaging. Ross McGuffie advised some individuals did meet this criteria but
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17 could only identify limited beds which took 7 days for them to be ready. Need to be careful if using this approach ensuring it is right for individuals. Maddy Halliday noted if some providers are unable to continue their services this would put additional pressures on the services, what is the awareness around some of those close to this. Ross McGuffie noted this is challenging to obtain data on as each provider is different but there are some providers struggling already so supporting them as best we can currently Have the sustainability payments for providers to access. John Watson noted vacancies across the council are at a critical staffing levels, need to look at attracting new staff and also on how to retain current staff not moving to other areas. Ross McGuffie advised currently working on some resilience work to see what is available and maximise recruitment learning from approaches used by other partners. Alison Gordon advised been working with HR colleagues to manage issues- looking at general support and also support around finance. Alison offered to meet John Watson to discuss out with the meeting to discuss most recent work undertaken. Cllr Kelly offered assurance that concerns raised are being managed. Cllr Brennan asked would there be merit to look at short liaise with those providing meals. Ross McGuffie certainly something can look into in future. The IJB agreed the contents of the Climate Change report prior to its submission. 18. Risk Ross McGuffie noted there will be continual review of cost of living risk by the HSCP team prior to next meeting 19. Date of Next Meeting Stacey Connor to issue members with future dates.