Minute
North Lanarkshire Council · 22 March 2023
Back to Health and Social Care Integration Joint Board — 22 March 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 ITEM 3 Integration Joint Board Committee Minutes from a meeting held on Microsoft Teams on Wednesday 22nd March 2023 at 2pm-4.20pm Present: Voting Members: Ally Boyle NHS Lanarkshire Nominated Non Exec Director Councillor Gerry Brennan North Lanarkshire Nominated Councillor Councillor Bob Burgess North Lanarkshire Council Nominated Councillor Philip Couser NHS Lanarkshire Nominated Non Exec Director 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 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 Anderson Support Services Project Manager 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 Dr Lucy Munro Medical Director NL Des Murray Chief Executive NLC Fiona Owens Audit Scotland Dr Tyra Smyth General Practitioner (GP) Maggs Thomson Head of Health North HSCP
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2 APOLOGIES: Dr Kenneth Dagg Secondary Care Medical Practitioner James Muir NHS Lanarkshire Nominated Non Exec Director 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 (30th November 2022) 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. He drew attention to the below updates: Item 8 Mental Health Continuing Care Contracted Beds – Ross McGuffie confirmed there are on-going discussion with providers and families to plan move of beds. Item 11 Provision of smoke alarms- Ross McGuffie advised update will be provided as part of the broader technology team once all work is completed. 5. IJB Reserve Strategy Consistent with a number of other Health and Social Care Partnerships, an underspend was reported to the IJB on 22 June 22 totalling £74.67m and was transferred to reserves. This 2021/2022 underspend included funding received to meet the ongoing cost and recovery to the Covid-19 pandemic and also funding made available by the Scottish Government to progress policy commitments and national priorities. The IJB Reserves Strategy 2022/2023 provides an opportunity to strengthen long-term financial sustainability by considering the allocation of the 2021/2022 underspend to the strategic priorities of the IJB and both partners. The IJB Reserves Strategy 2022/2023 will enable the IJB to balance current commitments whilst planning and addressing financial risks.
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3 It is essential for the long-term financial stability and the sustainability of the IJB that sufficient funds are held in reserve to manage unanticipated pressures from year to year. The requirement for financial reserves is acknowledged in statute and is part of a range of measures in place to ensure that section 106 public bodies do not over-commit themselves financially. The reserves balances at 31 March 2022 were £119.452m. This figure comprised of £70.05m earmarked reserves to support the delivery of projects which span financial years and £45.718m ring-fenced monies to enable the IJB to deliver on specific Scottish Government funded programmes. The remaining balance of £3.684m, is contingency reserves which are not held to meet any specific liability and offer the IJB some flexibility to deal with unforeseen events or emergencies. Some reserves where set aside for project which were no longer required and there has also been new reserves identified which require funding so this has led to the review of the strategy. It was proposed to move £900k to education services for school counselling service appointments to support the CAMHS services. This was support by the committee. John Watson queried is it within the IJB guidelines that the committee can hold reserves, Ross McGuffie confirmed this has been the case since the IJB was established. Brian Moore asked will further updates come back to the committee and would it be possible to show what is aligned to SCP. Amanda Kilburn confirm she will provide the committee with further updates in due course and can demonstrate what is aligned to the strategic commissioning plan. The IJB agreed the following recommendations: (1) Note the contents of the report; (2) Approve the proposed transfers to earmarked reserves in section 7.5 and (3) Approve the proposed realignment of reserves in appendix 1. 6. Medium Term Financial Plan 2023 The Medium-Term Financial Plan (MTFP) outlines the financial challenges and opportunities the Health and Social Care Partnership (HSCP) face over the next three years and provides a framework which will support the HSCP to remain financially sustainable. It will complement the Strategic Commissioning Plan 2023 – 2026, highlighting how we will support the delivery of the IJBs strategic objectives and priorities.
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4 Year 2022/2023 2023 to 2030 Contingency Reserve % 3% 5% As part of the development of the financial plan and in line with the North Lanarkshire IJB Medium to Long Term Financial Plan 2020/21 to 2029/30, if possible, it is recommended that the risk-based and contingency reserves are established as a percentage of the financial envelope as follows: The IJB contingency reserves currently equate to 2% of the financial envelope, however, following completion of the 2022/2023 financial year end, it is anticipated this percentage will increase. The plan will be updated when more information is provided. Phillip Couser queried what do we do around recurring savings. Ross McGuffie acknowledged the relationships with partner organisations has helped the financial situation. The aim of the SCP is to link with savings plans to build for the next financial year. Maddy Halliday asked for the underspend, is there any scope to look at different provision for the funding if there continues to be a challenge to recruit to certain areas. Ross McGuffie acknowledge this has been the case in the past so services will have a look at different skill mixes for services models in future. The IJB: (1) Note the assumptions and context of the financial plan; and (2) Approve the Medium-Term Financial Plan 2023 - 2026. 7. Financial Monitoring The report tabled 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 3 February 2023. The IJB year to date position is an underspend of £13.75m and the projected outturn for 2022/23 is an underspend of £16.199m, assuming the current trajectory of spend continues throughout this financial year. Subject to IJB approval, this estimated underspend will be allocated to manage, on a non-recurring basis, ring-fenced commitments, additional future business plans and any funding gap which may be highlighted in the North Lanarkshire IJB Medium Term Financial Plan 2023-2026. The following provides a high-level summary of the key pressures and the main reasons why the IJB is currently projecting an underspend against its budget this year:
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5 Employee Costs net underspend of £12.205m: as previously highlighted there are ongoing challenges in terms of recruitment and retention issues across all service areas. For a wide range of posts recruitment has been unsuccessful due to the availability of the skills mix required or the competition being offered by other private and public sectors. These are issues that are being faced by IJBs across Scotland. Home Support net overspend of £0.542m: within Home Support Services, employee costs have increased as the service continues to support delayed discharges and demand however, this additional cost is being part funded from an earmarked reserve and the current number of vacant posts throughout other parts of the partnership. Payments to Other Bodies net underspend of £2.840m: the underspend is primarily due to the staff shortages and vacancies within the Care at Home sector who provide services to individuals via the self-directed support commissioning framework. There is also an underspend in package costs due to slippage in Self-Directed Support (SDS) start dates. It is anticipated these are in-year underspends only and the full budget will be required in future years. Independent Care Homes net overspend of £0.788m: there are currently 1,503 care packages within this service however when the budget was set for this financial year, it was based on 1,461 care packages. Included within this overspend is £252k interim care bed expenditure, which will be offset by a 25% funding allocation from Scottish Government in relation to winter planning. Admin Costs net underspend of £1.884m: within the carers funding there is currently an unallocated budget of £1.8m. Work is continuing to allocate this is relevant carers package in 2022/23. At year end, any remaining underspend will be transferred to a dedicated earmark reserve to fund carers pressures in 2023/24. Prescribing net overspend of £0.300m: activity and cost per item within prescribing is 4.6% higher compared to the same period last year, which has caused this budget to move from a breakeven position when last reported to the current overspend position. Due to the uncertainty around costs and prescribing activity and the three-month time lag in receiving the data, the volatility experienced within prescribing is likely to continue for the foreseeable future.
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6 Brian Moore asked is there any scope to move away from using agency staff, is there other options we can consider to reduce this cost. Trudi Marshall noted undertaking work in Nursing, Midwifery & Allied Health Professionals (NMAHP) to reduce agency costs at a national and local level. Have agreed to move back to national framework which means the costs will reduce and starting to look at introduction of other types of roles within departments. Lucy Munro added will be looking a medical locum spend also. The IJB agreed the following recommendations: Note the contents of the report; and Note the financial position is a year-to-date underspend of £13.75m 8. Delegated Health & Social Care Budget 2023/2024 As reported throughout this financial year, the IJB will deliver an underspend on its core budget. The IJB projected underspend of £16.199m for 2022/23 financial year takes into account the ongoing challenges in terms of recruitment and retention across all service areas. These are issues that are being faced by IJBs across Scotland. Similar to social care, demographic and socio-economic factors continue to drive significant demand and cost pressures for our delegated health services in 2023/24 including: Pay inflation and the impact of agenda for change. Inflationary cost pressures across service level agreements on non-pay budgets. Prescribing cost, volume, and short supply impact. Using a range of informed assumptions, the CFO has estimated that the demand and cost growth for health services (not including Set Aside) in 2022/23 linked to the areas highlighted above, is likely to be in the region of a gross increase of circa £10m. The NHS Lanarkshire Health indicative budget offer for 2023/24, is based on an uplift of 2% and is in line with the letter of the 15 December 2022 from the Director of Health Finance and Governance. It is anticipated that a formal budget offer will be issued following NHS Lanarkshire board approval. The IJB agreed the following recommendations: Agree to accept the delegated social care budget for 2023/24 in section 9.4; Agree to accept the delegated health budget for 2023/24 in section 10.4 subject to: - the expected uplift of 2% reflecting the boards uplift for 2023/24; - any final adjustments in relation to recurring budget adjustments at month 12; and
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7 - any further funding allocated by the Scottish Government. Approve a drawdown of reserves, if required, in order to fund any shortfall in funding for 2023/24 and Approve increases to the IJB’s contingency reserves in 2023/24, through the appropriate utilisation of permitted financial flexibilities, in order to protect the financial resilience of the IJB. 9. Annual Audit Plan Fiona Owen attended the committee to present the external audit plan. There continues to be a significant risk of cyber-attacks to public bodies, and it is important that they have appropriate cyber security arrangements in place. A number of recent incidents have demonstrated the significant impact that a cyber-attack can have on both the finances and operation of an organisation. In 2022/23, we will consider North Lanarkshire IJB’s arrangements for managing and mitigating cyber security risks. This is a presumed risk contained within every audit. The Annual Audit is planned to be signed off at the September IJB committee. Maddy Halliday welcomed point 26 “The Auditor General and Accounts Commission are developing a programme of work on climate change. In the third sector support for community climate is being considered; this was noted. The committee noted the report. 10. Resilience Update NHS Lanarkshire stood down its Live Covid Incident in January 2023, however, the operational pressures emanating from the pandemic recovery have been pronounced, with NHS Lanarkshire in Black status since 27th July 2022. Operation Flow was developed to create a ‘firebreak’ to rapidly reduce hospital inpatient capacity, then creating the staff capacity to work on service redesign to bring the system as a whole back into equilibrium. Following the 9-day firebreak, hospital inpatient capacity reduced by around 15% across Lanarkshire, supporting the system to move from black to red status on 6th March 2023. Following extensive whole-system collaboration and planning, the Firebreak commenced on 23rd February and ran until Friday 3rd March 2023, covering the following coordinated actions:
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8 Mobile multi-agency team undertaking daily review of all acute inpatients across the 9 days, with the aim of identifying actions that can be taken to facilitate discharge or transfer to a more appropriate location to reduce the number of additional patients across our Acute Hospitals. Mobile multi-agency team undertaking daily review of all patients in an offsite bed across the 9 days to create flow from our Acute sites. Mobile Multi-agency teams capturing the number of clinically stable patients who are waiting for a diagnostic test by modality to expedite these tests/procedures to facilitate discharge. Provision of professional to professional clinical decision making support for care home residents prior to conveying to hospital. SAS crews using consultant connect to access support / advice from Emergency Medicine colleagues for patients prior to making a decision to convey to hospital (excluding 999 category patients). Reduced number of access routes to hospital based urgent and emergency care. All potential referrals to Emergency Department, Care of the Elderly and Hospital @ Home from SAS crews via Consultant Connect to determine if there are other alternative care options rather than hospital (excluding 999 category patients). Expanded access to Ambulatory Care during the Firebreak period by increasing hours of operation over the weekend period and redirection of patients referred by NHS 24 on 111 to treatment rooms for wound care, minor burns etc. Increased senior clinical decision maker resource in Hospital @ Home to support more people in the community for the duration of the Firebreak period. Increased capacity within Home Assessment Teams within Wishaw and Cumbernauld areas to support discharge. Councillor Gerry Brennan queried was the firebreak labour intensive and could this be continued in future. Ross McGuffie confirmed it was labour intensive with overtime and weekend working in place to support the work. Will consider ways that this work can be used in future to support winter planning. Ally Boyle asked how will space be built in for learning from the work undertaken. Ross McGuffie advised the aim of the firebreak was to get stability across the whole system. Which was evident in being able to moved down from Black status. Really improved relationship and understanding across different services also. The IJB: (1) Note that NHS Lanarkshire stood down its Covid Live Incident down in January 2023, though command structures have been adapted to continue to focus on ongoing wider resilience challenges, specifically around service pressures
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9 (2) Note that NHS Lanarkshire was able to move from black to red status on 6th March 2023, following a successful ‘firebreak’ as part of Operation Flow 11. Amendment to Terms of Reference The Terms of Reference for the Integration Joint Board are formally set out in the Public Bodies (Joint Working) Integration Joint Monitoring Committees (Scotland Act) Orders 2014 with particular reference to the Scottish Statutory Instruments 2014 No.285. The Terms of Reference for the PFA were formally approved at the IJB meeting on 23 November 2017 and formally reviewed in March 2018 and December 2020. The IJB is asked to approve a further extension to the PFA Terms of Reference which is detailed at section 6. The IJB is asked to delegate to the PFA the power to approve the IJB Annual Accounts, effective from the financial year 2022/2023 and each year thereafter. This amendment would give flexibility allowing the accounts to be approved within the scheduled timetables of either the IJB or the PFA and would reduce the need for a further meeting to be convened. The financial information reported in the IJB Annual Accounts has been reported to both the IJB and PFA throughout the financial year. Subject to the approval of the proposed amendment by the IJB, the above responsibilities in respect of the consideration of the External Auditors Annual Audit report and the approval of the IJB Annual Accounts would be delegated to the PFA. Harry Robertson queried the membership of the group. Ross McGuffie confirmed at the start performance, finance and audit includes 3rd sector representations. The IJB approved the revised Terms of Reference for the PFA noting the changes outlined in section 6.3 of the report. 12. Risk Register Following discussions at the last meeting of PFA on 14th February 2023, there has been a number of changes in the risk register: 3 risks closed: o IJB 03/21 – EU withdrawal o IJB 08/21 – Financial Implications of Covid o IJB 09/21 – Impact of pandemic on implementation of the strategic plan 1 risk increased:
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10 o IJB 06/21 – Prescribing – increased due to the projected increased costs facing the partnership in 2023/24 2 new risks identified: o IJB 19/23 – Service sustainability – a broader risk on sustainability challenges, replacing previous risks on EU withdrawal and Covid o IJB 20/23 – Workforce sustainability – a broader risk on sustainability challenges, replacing previous risks on EU withdrawal and Covid There are currently two risks rated as Very High on the IJB risk register. IJB 06/21 – Prescribing Activity and Costs IJB 17/22 – Unscheduled Care There are eight high rated risks on the IJB risk register. IJB 01/21 - Financial Challenges IJB 04/21 - Notional Set Aside Budget IJB 12/21 - Staff Health & wellbeing IJB 14/22 – CAMHS IJB 15/22 – Cost of Living IJB 16/22 – National Care Service IJB 19/23 – Service sustainability IJB 20/23 – Workforce sustainability It is planned to use a future IJB liaison session for a risk management session to look at risks in greater detail. Maddy Halliday would welcome review of risks to identify interdependencies which require further review for links to the 3rd sector. Ross McGuffie acknowledged the risks noted are for the broader HSCP workforce inclusive of the 3rd sector. Brian Moore acknowledged the work which has gone into updating the risk register and inclusion of mitigations; this was noted. 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. 13. Risk Management Strategy This initial Risk Strategy was put in place for December 2015, and was since updated and approved at the IJB in January 2018.
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11 Over the last year, there has been significant development in the IJB’s approach to risk management, with the risk reports now forming a much more substantial item of business at IJB meetings. There are three main risk registers across the partnership: IJB Register outlining the strategic risks to the Integration Joint Board Health operational register, hosted within the NHSL system Social Work operational register, hosted within the NLC system Ross McGuffie wanted to acknowledge special thanks to corporate risk managers and their assistance in the process; this was noted. Ally Boyle noted the paper says for any risk that are high or very high they are above tolerance will this be the case going forward. Ross McGuffie noted this has always been the case, there has been an increase in risk profiles aim to maintain a score of 10 or below going forward. Future reports will be more focused on the risk scoring and what actions will assist in lowering the scores. Maddy Halliday would be keen to explore risk appetite and innovation to learn and approve particularly with new projects. Ross McGuffie confirmed this can be covered as part of risk session. The IJB approved the new IJB Risk Management Strategy. 14. Category One Responders On 15th January 2021, the Cabinet Secretary for Health and Sport wrote to confirm the intention to include IJBs as Category 1 Responders on conclusion of the consultation. The North IJB welcomed the proposed change to make IJBs formal Category 1 Responders, whilst noting the positive local arrangements already in place that have seen the IJB fully embedded in the local resilience partnership processes for some time. Through the WoSRRP, a short-term working group was convened with IJB Chief Officers and West of Scotland leads to gain assurance around the IJBs’ preparedness and integration into the wider resilience community following their categorisation as Category One organisations in 2021. Through this process it was agreed to conduct a survey with all West of Scotland IJB’s and Local Resilience Partnerships to gain assurance that the IJBs were now fully embedded within the local resilience structures, in line with the expectations set out in the Act.
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12 Within the Lanarkshire Resilience Partnership, a collaborative process was undertaken to complete the survey in conjunction with the two Councils, NHS Lanarkshire and the two IJBs. The North Lanarkshire IJB/HSCP is well embedded in the Local Resilience Partnership structures, at both the strategic and operational levels. The IJB/HSCP has active Business Continuity Plans; is tied into the multi-agency emergency plans and has played a full and active role in a number of planning exercises. The IJB: 1. Note the progress made in confirming identified resilience leads; 2. Note that local resilience plans will be updated once further guidance is received. 15. Strategic Commissioning Plan 2023-2026 The Board approved the draft version of the Strategic Commissioning Plan at its meeting on 30 November 2022, subject to final consultation during the months of December, January, and February. The draft plan was published online in early December, alongside a survey questionnaire which allowed members of the public and any other interested parties to give their feedback on the draft plan. Feedback was generally positive and additional suggestions have been incorporated into the final draft. The feedback from the survey is published as an appendix to the final Strategic Commissioning Plan. A programme of work is set out within the plan outlining the key work programmes that will be undertaken over the three-year period to meet the key priorities within the Strategic Commissioning Plan. Key deliverables and timescales will be further developed, with regular reports on progress to be made to the Board and its Committee. The approach to the development of the plan and the completion of the process has been overseen by internal audit. The final version of the plan, once approved, will be graphically designed, and published online. A first draft of the plan was published for consultation in February and feedback has been incorporated within the final draft version of the plan attached to this report. The next steps will be to develop the programme of work alongside the plan, it will include a project management approach to key areas. Harry Robertson asked how can we analyse usage by Northern corridor patients going to other Health Board services. Morag Dendy noted using local intelligence to help explore data.
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13 Phillip Couser expressed an interest in accessibility of the document to the general public in a summarised format. Morag Dendy advised will make use of the new HSCP website to draw attention to key elements of the overall plan. Brian Moore asked how do we use this information through the IJB to get an oversight of data collected particularly around future resource use. Morag Dendy confirmed it will be part of locality planning groups to inform future discussions required. Maddy Halliday asked if there is any other feedback from other stakeholders and she asked if wording can be changed to be more inclusive for 3rd sectors. Morag Dendy was happy to accommodate in anyway possible. Ally Boyle noted the plan was taken to population health committee and it was well received. The needs analysis within the report provides a strong insight and should be used as a ’predictive needs assessment’; this was noted. The committee approved the final version of the SCP. 16. HSCP Website Update The HSCP North Lanarkshire is fully committed to promoting and facilitating the active involvement and engagement of the public, people who use services, carers, the community, voluntary and the independent sector, wider partners, staff and potential staff across all levels of the whole health and social care partnership. A key strand of facilitating that active involvement and engagement is a great website. The new website was launched at the end of February 2023 which brings together months of work from a wide range of staff and partners and catches up on time lost through the pandemic. Mark Dell advised use tools to scan website to identify any accessibility issues and it is now managed in house so changes can be made easier. The IJB: (1) Note the launch of the new website (2) Request that further reports are brought on the performance and analysis of the use. 17. Chryston Community Health Clinic Update From 1st April 2014, Health Board boundaries were realigned with those of the Local Authorities across Scotland, with the aim of reducing administrative barriers and ensuring full alignment with the integration of health and social care services as set out in the Public Bodies (Joint Working) (Scotland) Act.
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14 This boundary change aimed to facilitate the development of integrated services across all areas of Scotland. The change resulted in the Northern Corridor (covering the areas of Moodiesburn, Muirhead, Chryston, Stepps, Gartcosh and Auchinloch) being transferred into the NHS Lanarkshire (NHSL) boundary. Due to the limited capacity of this facility, NHSL was unable to fully repatriate services from NHSGG&C, resulting in northern corridor residents having to travel significant distances across Glasgow to access some health services, with teams and clinics based in a range of areas including Shettleston, Kirkintilloch, Easterhouse and Bridgeton. A Service Level Agreement (SLA) continues to be in place and as of February 2022 this exposed H&SCNL to a £392k financial gap if services where to be delivered with the known funded establishment and skill mix of the NHS Lanarkshire service model. It was also recognised in February 2022 that to support the smooth transition, clinical safety and continuity of care there would be an expectation of double running costs for a period of 3 months, equating to an increased cost of £212k for that quarter. In conclusion, the report confirms that Chryston Community Health Centre has been commissioned by NHSL in partnership with NLC and is on track to be operationally available for service delivery from August 2023. In tandem with the build programme, work is ongoing to repatriate the identified services, with work ongoing with both finance and operational teams. The IJB has already approved additional funding to support double running costs for one quarter, as well as additional recurring funding to support the roll out of the NHS Lanarkshire service models in the area. Work continues between the two finance departments around the financial transfers and further updates will come to the IJB once finalised. The IJB: 1) Note the active and ongoing progress with the delivery of this capital programme. 2) Note the progress with the repatriation of the clinical services from NHS Greater Glasgow & Clyde (NHSGG&C) and their associated Health and Social Care Partnerships (HSCP’s) 18. Improving Cancer Journey Following a paper being presented to the IJB on the 22 June 2021 endorsing the phase 1 application to Macmillan Cancer Support to access funding of £2m to improve the cancer journey across Lanarkshire, the paper today seeks agreement to Phase 2 of the application.
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15 In June 2021 the North Lanarkshire IJB endorsed Phase 1 of a two-part application to the fund to scope the local approach in partnership with VANL. The application to the fund was seen as an opportunity to align the ICJ approach to the Community Solutions work led by VANL. Improving the journey for people with a cancer diagnosis and for those affected by a diagnosis aligns closely to Community Solutions health and social care investment programme focused on building communities where people can have full, independent lives. A Programme Manager was jointly appointed by North Lanarkshire HSCP and the South Lanarkshire HSCP to lead on the implementation of the Improving Cancer Journey Programme across Lanarkshire. The total cost of this post was included in the South Lanarkshire HSCP application and is £0.382m over the five-year period of the programme to 2026. It was intended that the second part of the bid be submitted to secure additional funding of £652,000 to invest in localities to further develop and expand services and support to improve the cancer journey. The second phase of the project being targeted to areas of greatest need and where maximum benefit will be secured. Ally Boyle noted his endorsement for the service provision provided and links to other work within Lanarkshire. The Committee: Endorse the application for funding from Macmillan Cancer Support to implement Phase 2 of the Improving Cancer Journey approach in order to develop the support for people with a cancer diagnosis and those affected by a diagnosis to improve the cancer journey for individuals, their carers, their families and friends. 19. Chief Social Work Officer Annual Report In line with guidance this report is approved through the Council and this approval is exercised both through the Adult Care and Social Work Committee and the Education, Children and Families Committee. The Adult Care and Social Work Committee approved the report on 21st February 2023 and the Education, Children and Families Committee will consider the report on 28th February 2023. The report is presented to the Integrated Joint Board in order to provide an overview of social work activity and performance for the period 2021/22 in addition to providing context relevant to service delivery with respect to governance, resources, workforce, challenges and opportunities. A number of areas covered within the report will already have been the subject of more detailed reporting to the Board over this period however this overview is
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16 intended to facilitate the Board’s oversight, scrutiny and future planning with respect to social work services. Ally Boyle is there consideration for staff being able to access funding to qualify as a social worker as some are self-funded. Alison Gordon advised this a professional where there is not a national bursary process, previously Lanarkshire did have an internal programme but it was suspended. Funds have been set aside to re-open this to improve staff pathways into the profession. John Watson asked has there been any progress for social work recruitment and he noted there are difficulties with recruitment and foster carers. Alison Gordon advised for recruitment looking at what can be done within the current context but this is a national issue and we are supporting years in practice for newly qualified social workers. Seeking new ideas on how to recruit foster carers within local communities. There is a dedicated team for kinship carers who link with other teams to provide support. Brian Moore noted one of Lanarkshire risks was around public protection and failure to identified harm, are there gaps around responsibilities of staff. Alison Gordon noted we need to pay attention to emerging risks and ensure all staff have a basic awareness of their responsibilities. Phillip Courser asked does technology issues within social care hold back the services. Alison Gordon noted do rely on qualitative stories and experiences to back up information collated. Have commissioned a new database for social work to get an opportunity to pull and manipulate information. The IJB agreed the following recommendations: (1) Endorse this report (2) Note the approval route through Council committees. 20. IJB Directions Report 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 attached at appendices 1 and 2 within the report and, following the approval of the IJB, will be issued to North Lanarkshire Council and Lanarkshire Health Board by 31st March 2023.
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17 The focus for the year ahead will be on implementation of the year 1 programme of work of the IJB’s new Strategic Commissioning Plan, 2023- 26. The financial resources available are detailed in annex 4 of each direction. The budget for 2023/24 is indicative at this stage. A range of estimates have been agreed the Director of Finance of NHSL and the Head of Financial Solutions of NLC in respect of the preparation of the IJB Financial Plan 2023/2024 which will be updated during the course of 2023/2024 when costs and additional funding, as appropriate, are confirmed. As part of the detailed budget setting process, the financial allocations to each partner will therefore be finalised by the IJB Chief Financial Officer, in consultation with the Director of Finance of NHS Lanarkshire and the Head of Financial Solutions for North Lanarkshire Council. Ross McGuffie advised work is on-going to change templates to be more inclusive of directions and to update the committee more often; an update of this work will be brought to a future committee. The committee agreed: (1) Seeks the approval of the IJB for the issue of the directions to each partner for 2023/2024 in line with the new Strategic Commissioning Plan 2023-26 and the IJB Financial Plan 2023/2024. 21. Volunteering Strategy Report The purpose of this strategy is to set out partnership goals and activities to strengthen volunteering across North Lanarkshire, building on the significant progress that has already been achieved locally and contributing to achievement of the national Volunteering Framework and outcomes. The committee approved the report which will be designed prior to publication. 22. Risk There were no new risk identified by the committee. 23. Date of Next Meeting 17th May 2023 9.30am-12pm