ITEM 3 (M) IJB PFA 23.10.2024 (checked)
North Lanarkshire Council · 25 February 2025
Back to IJB Performance, Finance and Audit Committee — 25 February 2025 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 ITEM 3 Integration Joint Board Performance, Finance & Audit Committee Minutes from a meeting held on Microsoft Teams on Wednesday 23th October 2024 14:00-16:30 Present: Voting Members: Councillor Claire Barclay North Lanarkshire Council Nominated Councillor Councillor Bob Burgess North Lanarkshire Council Nominated Councillor Councillor Paul Kelly Siobhan White North Lanarkshire Council Nominated Councillor Phillip Couser NHS Lanarkshire Nominated Non Exec Director Brian Moore (Chair) NHS Lanarkshire Nominated Non Exec Director Non-Voting Members in Attendance Professional Advisors: Claire Rae Chief Officer, North Lanarkshire HSCP Stakeholders: Harry Robertson North Lanarkshire Carer Together Liz Seaton Partnership for Change User Rep John Watson Unison Rep In Attendance: Stacey Anderson Support Services, Project Manager Rose Walker (Minutes) Minute Secretary Mark Dell Communications Manager Morag Dendy Head of Planning, Performance & Quality Margaret Flavell Joanne Jenkins Nurse Director (interim) North HSCP Thomas Moan Dr Lucy Munro Medical Director North HSCP Maggs Thomson Head of Health NHSCP John Watson Maria Williamson Senior Manager, Quality Assurance David Wood Harry Robertson (Guest) Dawn Wright Management Team Secretary, North HSCP Apologies: Nauman Dar NHS Lanarkshire Nominated Non Exec Director Diane Fraser Alison Gordon Head of Adult Social Work Services
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2 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 IJB PFA 21st August 2024 The previous minutes were approved as an accurate reflection of the discussion. 4. Matters Arising/ Action Log There were no matters arising. Brian Moore referenced the discussion from previous Integration Joint Board (IJB) meeting around the numbers of Care Inspectorate reports that some services were subject to, and asked if there was any feedback to the frequency and numbers undertaken. Claire Rae, Chief Officer, North Health and Social Care Partnership agreed will pick this discussion up and feedback to members of the group. Noted that the Audit Scotland report was recently discussed within an IJB meeting, and suggestion made that the recommendations within report be incorporated on the IJB Action log. It was noted on review there is a number of actions remaining. To review recommendations within a liaison session in the context of medium term financial planning arrangements. Claire Rae advised update will also be provided at the IJB meeting scheduled 4 December 2024. 5. Getting It Right For Everyone (GIRFE) Morag Dendy presented the Getting it right for everyone (GIRFE) paper highlighting is a national piece of work supporting Adults in a much more person centred way. The paper outlined a proposed multi-agency approach to support and services from young adulthood to end of life care which the Scottish Government is co-designing with place-based pathfinders. Health and Social Care North Lanarkshire North Lanarkshire is a place-based pathfinder for older people and frailty.
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3 The Pathfinder programme began in January 2023 and is underpinned by a co-design approach including: • GIRFE Design School - a support model which can help teams to come together, get ready for co-design work, and engage people with lived experience on a specific policy area, problem exploration or redesign challenge. • GIRFE Learning Networks to support a national practice model. There are eleven place-based pathfinders across Scotland aligned to five thematic areas: 1. People in prisons. 2. People in addiction services. 3. People registered at Deep end GP Practices. 4. Families with multiple and/or complex needs and young people in transition from GIRFEC to GIRFE. 5. Older people and frailty. The North Lanarkshire pathfinder was geared towards a focus on frailty given the population projections of North Lanarkshire and a need to reduce demand and pressure on health and social care services. The North Lanarkshire pathfinder work sought to achieve three main things. 1. To understand people’s experiences of accessing health and social care services in a range of different settings, across thematic areas and focused geographically on Wishaw (although wider engagement took place). 2. To embed their expertise and knowledge into the final version of the principles and elements of a national toolkit that would support the approach at a local level. 3. To ensure, through the governance structure adopted, continued alignment with the Strategic Commissioning Plan programme of work and delivery plan for Back to Basics, that adopts the Human Learning Systems (HLS) approach. Morag Dendy added that a lot of the work nationally fits with priorities locally in relation to how we help people to help themselves first; to how it is influenced locally and influence on a national context. Phillip Couser asked what confidence do we have; that we have this access to the data; to properly assess the impact and performance of this? Morag Dendy advised that benefits have been realised from the collaborative work undertaken with colleagues in Airdrie and Wishaw locality which had also provided the opportunity to test, explore and identify areas of improvement. Margaret Flavell added that one of the Pathfinders is meeting with some of the operational staff involved in the Wishaw demonstrator and is speaking with people with lived experience. The team have linked closely with the performance team to analyse and interpret the data.
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4 Brian Moore referred to the following highlights within the report and sought clarity in relation to: 1. The development of digital requirements; asked has this been advanced? 2. Did we get the toolkit in September 2024? 3. The sticky person; who do we envisage in fulfilling that role? 4. In terms of the Governance framework; the IJB is not mentioned 5. Under 6.4.1 the risks that are outlined makes reference to finance; trying to get a sense of the timeline and the process for rolling this out across different localities. What are the financial implications? 6. In terms of the demonstrator sites, Airdrie and Wishaw and its reference to community nursing. How does that overlap with the next paper on the agenda where reference is made to a single point of access for community district nursing? Morag Dendy replied; in terms of the digital requirements, the Scottish Government, share the frustrations by the slowness and progress in relation to how a national digital approach would assist the work “It's an area that we continue to feed into”. The tool kit, this is a bit more of a practical document. What we aim to do, is to embed in to our operations and not to make this feel like it's something different and additional. The focus is on how does this fit with a wider approach which helps us to be able to test the content broadly, but not necessarily adhering to the format that the Scottish Government have shared. Additionally, in relation to sticky person, the enabling approach encourages a place based opportunity to think about the people resources and wider community resources within a locality is encouraging us to really identify a lead that makes sense for each person in that context. A sticky person could be anyone in relation to people employed through statutory organisations, third sector partners, and the Community connector roles. Morag Dendy added in regard to the financial implications, it is about streamlining current operations into a more whole system way of working. With robust reviewing processes in place, to ensure we are doing things right first time. This will allow us to refine the way of operating for efficiency and effectiveness from the start, with not over-supporting or dealing with the impact of under-supporting. The single point of access from community nursing is about no waits, . how do we respond quickly, considering how do we do that in a way that takes from the lessons learnt from the work that Podiatry and CAMHS have done. It's our responsibility to consider how we undertake these streams, and get the right response in place for people to join in a locality based approach. We have structures in place that will help us learn collectively. Cllr Barclay commented on looking at Lanarkshire as a whole; referring Airdrie, Wishaw, and with Cumbernauld the point was made that there can be differences between areas sometimes and statistical outliers; is the GIRFE model flexible enough to take into consideration all of this?
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5 Morag Dendy advised the focus has been on Airdrie and Wishaw. The back to basic work has included all of the localities, however we are confident that we will get to a model that will respond to the uniqueness of the different localities. Margaret Flavell commented around the question raised regarding Governance; that the IJB was not specially mentioned. To note the Programme Board Governance structure was being refreshed at the time of the report, referred to the new Getting it right for everyone (GIRFE) board, sub groups below and pointed out this work would report in to that. IJB PFA Committee note and agreed the following recommendations: I. Endorse the GIRFE Pathfinder journey and approve the next steps. II. Endorse the testing of prototypes in multidisciplinary operational practice, through: III. The provision of and deployment of existing resources to ensure capacity, providing support and challenge via the Back-to-Basics governance structure to measure the learning IV. Embedding the GIRFE principles and subsequent practice and ways of working underpins the Back to Basics/enabling approach. V. Have requested to receive future reports with the national pathfinder learning. 6. Community Nursing Review Joanne Jenkins presented an update on the progress of Community Nursing Review. Community Nursing is a planned service that is delivered in all six localities and provides nursing care to people who cannot attend other care facilities or where being cared for in their home is considered the most suitable environment. This service was last reviewed in 2006 therefore a review of community nursing within North Lanarkshire HSCP was commissioned by the Nurse Director, Health & Social Care North Lanarkshire on 20th August 2023 with the aim to develop a model which meets the needs of our changing demographics and also to support improved workforce planning with clear career progression pathways. The Community Nursing review has now been completed and the implementation stage is ongoing. Demand for our health and social care services is ever increasing as people live longer but are often now living with multiple long term conditions and increasingly complex needs for health care and social support. Planned Project Objectives and Process • Develop a Vision for Community Nursing in Lanarkshire. • Map demography, local need and current service provision. • Develop a stakeholder engagement to ensure that we engage the community, staff and service users.
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6 • Develop a revised clinical model. • To develop a workforce plan – utilising the 6-step methodology of workforce planning. • To develop a training and development plan to support the new staffing model. • Review Governance for Community Nursing. • Implement recommendations of review and monitor impact on patient outcomes. Phillip Couser asked is there comparative data, to other areas, to see how the service is performing or is that still an area where this is general weakness. Joanne Jenkins advised that the project have found this to be a general weakness. Nationally conversations are being had as there is a drive for this; but don’t have the data at this time. Siobhan White asked around the training for newly qualified nurses coming in at different points; has there been lessons learned from new qualified staff; and shared practice to their experience? Joanne Jenkins advised this has been looked at for newly qualified nurses within development days, and try to take a consistent approach across North and South Lanarkshire. Brian Moore commented it is interesting to see the planned work with care homes and the benefits that may arise with same. Brian also referred to the social care issue and some of the tasks that might be transferred; social care as a reference to catheter bags and stoma care and asked how this is progressing? Joanne Jenkins advised is progressing well with positive feedback received. IJB PFA Committee note and agreed the following recommendations: I. The progress of the Community Nursing review. 7. CAMHS and NDS Recovery and Renewal Programme Board Dr Lucy Munro presented detail of scope and scale of modernisation that has been delivered by the CAMHS and NDS Recovery and Renewal Programme Board to facilitate delivery of a CAMHS and an NDS model aligned to the individual national specifications. The Lanarkshire CAMHS and NDS Programme Board has been in place since 2021. The Programme Plan articulates how the National CAMHS Service Specification – as well as associated Scottish Government directives – will be locally implemented. The purpose of this programme was to assess, evaluate and where appropriate redesign Child & Adolescent Mental Health services ensuring a whole systems approach based on children and young people’s rights and relationships.
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7 There have been 6 work streams within the Programme. These have all either been fully completed or are well progressed to a business as usual model of operational delivery: - • Neurodevelopmental Service – all work completed. All neurodevelopmental requests for assistance are now channelled via established Neurodevelopmental Service. This combined 3 previous waiting lists (CAMHS, NDS and Paediatrics) and provided transparency of referral pathway, consistency of response and quality assurance of assessment. • Choices & Partnership Approach (CAPA) Implementation within CAMHS- all work completed. This new model of patient management has been operational since May, 2023. It can now provide robust data capable of assuring planning of service capacity and informing trajectories over a longer time period. • HR & Workforce – all work completed. A full review of workforce in line with CAMHS and NDS specifications was undertaken and professional and support staff gaps addressed. • Communication and Engagement- all work completed. An Engagement Officer role has established a process that facilitates consultation with children, young people and their families. • eHealth- all work completed. Trakcare build completed to facilitate delivery of CAPA Model. Electronic case record now in place across whole service. • Capital/Strategic Planning- ongoing. Large scale refurbishment delivered in South Lanarkshire. Work ongoing across 3 sites in North Lanarkshire to deliver same. Dr Munro reported the financial instability continues to challenge workforce stability. Claire Rae added in relation to the funding; there has been a significant reduction in the mental health bundle funding allocation that would cover CAMHS. The reduction will have a significant implication on our trajectories and performance. Claire provided assurance that both herself and the Director of Finance NHSL were in discussions with Scottish Government regarding the funding and further updates will be provided to the IJB. Cllr Barclay acknowledged compared to where we were, it seems work is moving in the right direction, and asked is it having an effect on the waiting time for people getting an appointment? Dr Lucy Munro answered yes. Have seen that improvement trajectory. Had seen a recent dip to 66% to 18 weeks, but expecting with the changes that have been made and the projections that we have from a Public Health Scotland analyst to be at 90% at 18 weeks for that first appointment. Added waiting lists are still too long; workshops are being held for people on these waiting lists; to offer support.
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8 Dr Munro outlined some of the diagnostic issues and challenges in relation to NDS and increasing demand for assessments. It was confirmed that lead civil servants share the views expressed at the meeting. Dr Munro added that Stephen MacLeod the Scottish Government advisor for CAMHS and NDS; brings this to the board. Brian Moore referred to the final recommendation; the remit of Programme Board will expand to include financial planning for workforce resilience. Brian Moore requested that an update to the IJB is required following the Scottish Government meeting to see what the short term and long term impact will be if of any financial reduction. IJB PFA Committee note and approve the following recommendations: I. The contents of report and progress made to date. II. Robust reporting is now available as an electronic patient management system with aligned electronic patient record is now in place. Performance is monitored and managed within the unit and formally reported via IQPR III. All work streams have completed work initially advised with exception of capital planning. However, this work is in progress and can be managed locally with support from planning colleagues. Additionally, the information available to us, due to improvements in robustness of data capture is capable of informing redesign in a way that was not possible in first phase of capital investment. IV. Ongoing work of the Board will focus on NDS and the interface of NDS with CAMHS. V. Remit of Programme Board will expand to include financial planning for workforce resilience 8. Paediatric Modernisation Board Maggs Thomson provided an update on the Paediatric Modernisation Board which was established in current form, formally, in February 2023. The Paediatric Board is focussed on modernisation of service delivery and clinical activity generated via acute hospital and aligned community based paediatric services. The delivery of the services within scope of board, inclusive of in-patient care are the responsibility of the Specialist Children’s Health Services Unit, and hosted on behalf of NHS Lanarkshire within North Lanarkshire Health and Social Care Partnership. The Board forms part of NLHSCP Strategic Commissioning Plan and reports to North Lanarkshire CORE, North Lanarkshire Integration Joint Board, South Lanarkshire Integration Joint Board and NHS Lanarkshire. The agreed remit of Board is: - • Ensure a collaborative, inclusive approach to the design and delivery of a programme of work to implement the Paediatrics Modernisation Programme Plan;
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9 • Monitoring the financial position across the Programme, including the use of Scottish Government funding for specific areas of work; • Encourage and strengthen links between the Programme, North and South Lanarkshire Paediatrics Services Plans and other relevant strategies of all key partners; • Approve Programme documents and deliverables; • Monitor the progress of Programme and delivery plans; • Approve significant changes to the Programme scope, objectives, deliverables, funding and timescales; • Provide assurance that outputs are operationally fit for purpose and implemented satisfactorily; • Identify and manage risks and issues ensuring mitigating actions; • Agree and track benefits realisation and achievement of outcomes; • Approve Programme closure following implementation and ensure that any end project reports, issues, lessons learned and risks are documented and passed on to the appropriate body. A three Horizon approach was taken to prioritisation and phasing of work to be planned and delivered: - Horizon 1- covers current issues that require quick response. • Nursing Care Assurance • Review of Continence Services Horizon 2 -covers emerging issues that are likely to be faced in the next one to three years. • Sustainability of medical rota Horizon 3 - covers issues that might come into play in the future. • New clinical model Brian Moore asked for further clarification on the statement that elements of this work being impacted by current service level agreements with partners and sensitive discussion via regional planning. He noted there is a big emphasis on regional planning within the national system at the moment; do you know what the implications are for this service? Maggs Thomson informed that the paediatric wards provide a District General Hospital level of care; currently in negotiations with our Glasgow colleagues to provide our tertiary level care and that's afforded through the SLA with Glasgow. It was noted the progress is still at early stages and assurance offered to members that work is being undertaken in these areas. Phillip Couser commented; the paper doesn't have any sort of hard timelines against which this work is progressing to deliver on and asked is there any risk that might change? Maggs Thomson advised the primary emphasis and focus in the first year was to start the shift in thinking and to get the right stakeholders around the table to build that level of confidence and trust, and to have plans on the table to see what could be delivered.
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10 Action/ Direction to service: Brian Moore asked when report comes back with an update, that additional information be provided to get a better understanding of the staff numbers working within the service as well as the budget and number of patients, inpatient and community supports. IJB PFA Committee note and agreed the following recommendations: I. the contents of the report and progress of work achieved to date. II. the scale of challenge to delivery of sustainable transformational change. The success of programme delivery will require clinical modelling and clinician support. This has to be balanced proportionately with safe delivery of care whilst transformational work progresses. III. that elements of this work are impacted by current service level agreements with tertiary partners. This requires sensitive discussion via regional planning process. 9. Speech and Language Therapy Service Improvement Maggs Thomson provided an overview of the scope and span of improvement work being delivered via Speech and Language Therapy (SLT) Service. The Speech and Language Therapy service is hosted within the Specialist Children’s Health Services Unit of North Lanarkshire HSCP and delivered pan Lanarkshire. The service is funded by NHS Lanarkshire and via service level agreement arrangements with north and south education departments. The service offers support to children and young people and separately, to adults. The service improvement work is focussed on delivery of improvements required to support improved access to speech and language therapists and interventions for children and young people. A Speech and Language Service Improvement Group was established at request of NLHSCP Chief Accountable Officer. The first scoping of service model and setting of priorities was undertaken in April 2023. As a result, areas of priority were agreed, and work streams established to progress work to date: - • Waiting List- This work is progressing well in a testing phase following review and standardisation of the processes that support patient pathway and inform digital plan. Agreeing, refining and developing core clinical offerings at Universal, Targeted and Specialist level. Ensuring workforce have the confidence, resources and knowledge to deliver the core service model • Digital - This work has progressed well. The service had no digital footprint. Trakcare has been implemented since September 8th, 2024.
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11 • Comms and Engagement - This work has progressed well. Colleagues within the service had already well-established social media platforms and information and education via YouTube that was used to support children and young and their parents and carers. • HR and Workforce -This work has progressed well. Review of all posts across the service has been undertaken. Brian Moore commented in terms of paediatrics and CAMHS; the benefits of making connections with district nursing review and particularly the reference in the performance report to restrictive locality working arrangements, there needs to be a fundamental rethink of how we structure and deliver the service going forward. Maggs Thomson clarified whilst delivering in localities the services are reviewed on a Lanarkshire wide basis. IJB PFA Committee note and agreed the following recommendations: I. Note the contents of the report and progress of work achieved to date. 10. An update on Care Academy Morag Dendy provided an update on the Care Academy which is a collaborative initiative between NHS Lanarkshire, North Lanarkshire Council and South Lanarkshire Council. It reports through both North and South Lanarkshire Council’s committee structure. The Academy is authorised to work with partners such as local councils, education departments, colleges, universities, the independent sector and third-sector organisations to attract and recruit staff to the health and social care workforce. The overall vision for the Care Academy is to develop a robust, sustained, vibrant Care Academy attracting and developing a diverse workforce for health and care services in Lanarkshire and promoting the sector as a rewarding choice for careers”. There have been four work streams now established, with specific actions within each being developed by the work streams themselves. A further update on progress on each of the work streams will be brought back to IJB in 6 months. Progress and updates are also provided through: • Brighter Futures Programme Board - North Lanarkshire • Social Work Resource and Finance and Corporate Resources (Personnel Services) – South Lanarkshire • Core management team of both HSCP’s – NHSL Cllr Paul Kelly commented, I think it's a really important piece of work around recruitment of new people into social care; one of the challenges that may be required was to identify is around the funding aspects, the different wage elements of care from your local authority, private third sector? and in terms of how we manage it.
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12 IJB PFA Committee note and agreed the following recommendations: I. The progress with Implementation of the Care Academy Pan Lanarkshire. II. a further update on progress with the work streams in 6 months’ time will be submitted to the IJB. 11. Performance Update – Quarter 1 (April – June 2024) Morag Dendy gave an overview of the Quarter 1 performance report detailing the areas for improvement identified in Appendix 1 and progress made to date. Noted the areas for improvement identified in Appendix 1 are being progressed as a matter of priority, and progress updates will be reported at future meetings of the Board and the Performance, Finance & Audit Committee. Phillip Couser commented on the broader societal issues that sit outside Lanarkshire that impact some of the metrics, asked whether or not a peer group review might help focus on areas where there is room for improvement. Brian Moore pointed out we have that covered in terms of the annual performance report where we are part of a cohort, and there was some benchmarking information. Claire Rae mentioned in terms benchmarking; this is something that we constantly strive to do in terms of looking and implementing learning from other boards and local authorities in terms of performance. Acknowledged in terms of annual performance report, going forward that we will include recognition of areas of success. Cllr Barclay referred to the referrals and the figures from adult protection concern reports; asked regards the dip in the number of cases, and wondered what are the reasons behind this? Morag Dendy advised very often the referral numbers can relate to good work being done, it is not so much of a lack of reporting. Note there is also a lot of work done through the Adult Protection Committee and the reporting there, which gives a lot more detail and feed through this forum. Brian Moore asked when looking at alcohol and drug services, do we know what the impact, of all the activity is and how we capture it? And suggested a more fundamental review of how we tackle smoking cessation. Cllr Barclay referred to sickness absence- In relation to COVID and asked is there stats being kept to say this relates to COVID and is that causing some sort of fluctuation within this, or is it is like the other organisations in that COVID has just been taken as part of absence reporting? Brian Moore informed the understanding is that this is now just part of absence reporting and Maggs Thomson re-iterated this is not reported separately and is just managed along with any other sickness absence.
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13 IJB PFA Committee note and agreed the following recommendations: I. Note the contents of the report and the appendix. 12. Tackling Poverty- Cost of Living Helpline Morag Dendy provided an update on the Tackling Poverty service. A key role of the Tackling Poverty Team is to support the income maximisation service through the First Point of Contact Team to residents, Support Services for fieldwork staff, supporting specialist Social Work Services, Education Services and Housing Services and the Resolution Team representing clients at tribunals and hearings. Successful welfare rights intervention, where individuals are awarded extra benefit, frequently mean that, as a result of increased income, they are better able to manage their own affairs and may not require further health and social work services. The Tackling Poverty Team monitors and records activity of the helpline, in number of people assisted, reason for referral, income generated, advice given, outcomes, number of people/referrals signposted to other services/agencies. Siobhan White asked is there some of this work being undertaken by other bodies anywhere ie. welfare officers helping people in one capacity and then the housing associations also. Morag Dendy advised that this work has a whole system focus in relation to the joint work with housing colleagues, including housing associations, and that the collaborative approach is fundamental in the tackling poverty approach. In the report there is reference to some maybe not to others, but they are actively involved in the overall approach and work with their housing colleagues in North Lanarkshire Council which gives us good routes into those wider links. Cllr Barclay added from an elected members point of view the one door approach has been phenomenal. Action / Direction to service - Brian Moore noted that post June 2025, to support the continuation of the of the helpline; an exit strategy or alternative funding will need to be identified by the service IJB PFA Committee note and agreed the following recommendations: I. Note the contents of the report. II. Endorse the report and note the impact of the funding of the Cost-of- Living helpline for residents III. Approve the request to extend the use the already earmarked funds (£600,000, from April 2023 to March 2025) to support the enhanced service to June 2025.
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14 13. Quality Assurance Annual Report Morag Dendy gave overview, of the Quality Assurance activity over the period April 23 to 31 March 2024 detailing Contracts & Contract Management, Regulatory Activity, Procurement, Complaints, Duty of Candour, Information Governance, Market Facilitation, In House Monitoring, Safer Staffing & Communications; highlighting the progress made within these key activities noted in the last reporting period, and advising of the developments in progress which are planned for the period 2024/25. There's lots of progress in relation to people who have experience of a need and support being involved directly. The activity in relation to regulatory contact through the Care Inspectorate is all captured. The report is reported through the Adult Care and Social Work Committee and through the Education, Children and Families Committee. Brian Moore commented on safe staffing; noting in terms of future work going forward the Quality Assurance team is going to look at this in more detail; highlighted an annual report to be submitted by April 2025. Suggestion made that members of the IJB PFA would benefit from having an understanding of safe staffing and some of the elements of it in terms of real time reporting and escalation. Pointed out it will be useful to bring an explanatory note to the IJB as there has been ongoing work on the health side, but it's also applicable to social care. It was noted there was zero findings of duty of candour this year and Brian Moore asked for comment regarding the absence of reports. Maria Williamson added that in previous years, have reported commissioning services duty of candour; there has been activity externally, just not internally. External organisations are required to publish their own reports. Going forward the duty of candour report that we publish will refer to our own services in terms of social care. IJB PFA Committee note and agree the following recommendations: I. Note and endorse the contents of the report. II. Remit the report to Adult Care and Social Work Committee. III. Request that an explanatory note to the IJB on safe staffing is provided at an IJB Liason session. 14. Community Solutions Annual Report Community Solutions is a successful, cross-sector health and social care investment and improvement programme for North Lanarkshire established in 2012 – aims to improve people’s health, wellbeing, quality of life, and equality by investing in community-led initiatives which build community, family, and individual strengths and resources, with a focus on prevention and early intervention.
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15 The Community Solutions Programme is a North Lanarkshire partnership initiative involving: • University Health and Social Care North Lanarkshire’s (UHSCNL) public sector partner organisations – North Lanarkshire Council (NLC) and NHS Lanarkshire. • Voluntary Action North Lanarkshire (VANL) - the programme’s host organisation. • The Community and Voluntary Sector (CVS) funded organisations and projects. Brian Moore mentioned in relation to Community transport; this may be an area where there could be future developments and asked around mental health and well-being funding; is there any indication as to the future, allocations in in the coming year? Thomas Moan replied seems to be very positive. On phase four, which will be allocated in the last quarter of this year for projects being delivered in 2025 from April 2035 to March 2026. Mental health and well-being is still a major issue. One of the areas that we're working closely with colleagues in NHS Lanarkshire, is to see how people with more severe mental health support needs, how we can complement from the Community voluntary sector. Philip Couser raised question in relation to funding; do we feel confident that we are able to demonstrate and defend the value that we're getting from these investments? do we have that sort of evidence? Do we have a framework by which we can judge the value that we are getting from these investments? Thomas Moan answered; have a quite a robust performance, measurement, evaluation, learning and improvement framework in place named Pemeli. The focus is on how can inform service redesign. IJB PFA Committee note and agreed the following recommendations: I. Note the contents of the report. 15. Whistleblowing Report North Lanarkshire Council’s Whistleblowing Procedure (attached at Appendix 1) has been reviewed and no amendments requiring approval are considered necessary at this time. In NHS Lanarkshire no new whistleblowing cases were raised during April, May and June 2024. One case raised in Q4 of 2023/24 was withdrawn, and one case initially raised in Q1 of 2023/24 continued to be assessed to determine if it met the criteria for Whistleblowing. One new potential case was raised in May 2024 and after further consideration the member of staff decided not to pursue the Policy. No new concerns were raised which were deemed appropriate for investigation under HR policies. Brian Moore commented in terms of where we are, is still early days and the fact that we have low numbers is something that we need to reflect upon. In
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16 terms of raising awareness and training; as an IJB will be seeking assurance that staff and managers are aware of the whistleblowing policy. Noted will continue to monitor on an annual basis. Maggs Thomson commented although we do not see a lot of whistle blowing numbers; one of the things we do see coming through is a fair number of anonymous complaints. When the party isn't known to anyone, and asked is this something we need to do to look at. Brian Moore added is a very valid point because the whistleblowing legislation doesn't cover confidential concerns, it does give guidance that it should be investigated as best you can under the circumstances. IJB PFA Committee note and agreed the following recommendations: I. note the update and the content of each Whistleblowing report and are assurance that whistleblowing standards are being followed and learning shared. 16. Risk Report The purpose of this report is to provide a summary to the IJB PFA on risk management activity, noting any amendments or additions to the current risk register. The IJB currently has 19 risks identified on its IJB risk register with 11 risk rated as high or very high. Noted no changes to risks this period. Very High Risks • IJB 06/21 – Prescribing Activity and Costs • IJB 01/21 – Financial Challenges • IJB 21/24- Pharmacy Pressures within Prison Services High Risks • IJB 04/21 - Notional Set Aside Budget • IJB 12/21 - Staff Health & wellbeing • IJB 15/22 – Cost of Living • IJB 16/22 – National Care Service • IJB 19/23 – Service Sustainability • IJB 20/23 – Workforce Sustainability • IJB 12/22 – Unscheduled Care • IJB 23/24- Speech and Language Therapy A comparative review was conducted of the corporate risk registers for North Lanarkshire Council and NHS Lanarkshire. the review also encompassed the Adult Health and Social Care Risk Register as well as the NL H&SCP Core Risk Register. Highlighted was that all four risk registers had the following risk themes detailed: • Financial Risks/ Financial Sustainability
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17 • Prevention and Detection of Fraud, Bribery and/or Corruption Cllr Barclay gave thanks to Stacey Anderson for hard work and displaying in this format for ease of reference. Brian Moore commented that the adult protection one is part of performance reporting and questioned the submission of a report from the Adult Protection Committee to the IJB in terms of understanding those processes. Noted for the next meeting, to discuss the potential inclusion of climate change in the risk register. Noted agency is currently not included in the IJB risk register, may need to be addressed. Lucy Munro added there’s a sustainability and value group which is led by looking at all of the agency staffing from a medical perspective and advised their maybe also be work being undertaken from a nursing perspective. IJB PFA Committee note and agree the following recommendations: I. noted the contents of the presentation which includes a review of the highest rated risks within the IJB risk register and a note of those operational risks highlighted by the Heath & Social Care North Lanarkshire partnership that impact upon delivery of IJB business. II. noted the inclusion of an overview of the corporate risk registers across parent organisations within North Lanarkshire. III. Have considered the inclusion of climate change and public protection risks to the IJB risk register to align risk sharing across parent organisations. With Climate Change risk being added to the register and further discussions to be held regarding the inclusion of a public protection risk at further IJB sessions. 17. Risk No other emerging risks identified to be added to the risk register. 18. Date of Next Meeting 27th March 2025, 14:00-16:30