Item 13 - Review of Integration Scheme
West Dunbartonshire Council · 25 October 2023
Back to West Dunbartonshire Council — 25 October 2023 and its agenda
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WEST DUNBARTONSHIRE COUNCIL Report by: Beth Culshaw, Chief Officer West Dunbartonshire Health and Social Care Partnership (HSCP) Council Meeting of 25 October 2023 Subject: Review of Integration Scheme 1. Purpose 1.1 The purpose of this report is to update West Dunbartonshire Council on work ongoing to review the Integration Scheme between West Dunbartonshire Council and NHS Greater Glasgow and Clyde, to present a draft revised Integration Scheme for comment and approval to go out for consultation. 2. Recommendations It is recommended that West Dunbartonshire Council: 2.1 Consider the content of this report; 2.2 Comment on the draft Integration Scheme; 2.3 Instruct Officers to consult prescribed consultees in line with the Public Bodies (Joint Working) (Scotland) Act 2014; 2.4 Instruct Officers to report back to West Dunbartonshire Council on 6 March 2024. 3. Background 3.1 The Public Bodies (Joint Working) (Scotland) Act 2014 (the ‘Act’) requires Health Boards and Local Authorities to jointly prepare an Integration Scheme. It sets out the key arrangements for how Health and Social Care Integration is to be planned, delivered and monitored within the local partnership area 3.2 Integration Schemes are required by statute to be reviewed within a “relevant period” of five years from initial publication. The Schemes for Integration Joint Boards across the NHS Greater Glasgow and Clyde Health Board area received parliamentary approval at different times and are therefore subject to different review schedules. In order to ensure consistency, where possible, across the six Integration Joint Boards and to reduce duplication of effort, in 2019 it was agreed to carry out simultaneous reviews to enable revised Schemes to be approved at the same time. 3.3 West Dunbartonshire Integration Scheme was the first to go live in July 2015 and therefore was reaching the end of its statutory period for review in June 2020. ITEM 13
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3.4 On the 26 February 2020, West Dunbartonshire Council considered a report from the Chief Officer, West Dunbartonshire Health and Social Care Partnership on this matter and agreed to note the content of the report and to approve the draft revised Integration Scheme for consultation. 3.5 On the 25 February 2020, Greater Glasgow and Clyde Health Board considered a similar paper. The extract of the minute of that meeting shows that “due to time constraints, Professor John Brown (NHSGGC Chairman) proposed that this item be deferred to the Board Seminar Session, which would take place in March [2020], to ensure sufficient time for consideration and approval.” 3.6 Due the global pandemic the NHS Board Seminar Session referenced in paragraph 3.5 did not go ahead and this work fell into abeyance. 3.7 This afforded officers a period of further review and reflection and in mid- 2021 the work was reinvigorated, with working group comprising of senior representatives from all six HSCPs, re-established to consider the content of the Integration Schemes. This group conducted a technical review of the 2020 drafts and considered how all six Integration Schemes could be more effectively aligned in terms of language and format with the aim of developing revised Integration Schemes for approval by all six Local Authorities, the Health Board and in due course the Scottish Parliament. 4. Main Issues 4.1 The technical review of the six Integration Schemes drafted in 2020 has taken place both locally and by the Greater Glasgow and Clyde working group and has identified where edits could be beneficial. 4.2 This review has also considered areas that are consistent across all six Integration Schemes and present for consideration updates of content to achieve a higher level of consistency. 4.3 Key areas of the Schemes that required some review and revision included the sections on Finance, Risk Management, Complaints and Information and Data Handling to reflect legislative changes and the transitioning from shadow arrangements to fully implemented IJBs. 4.4 The key substantive change included is in relation to Section 3 (Local Governance Arrangements) where it is proposed that the term of the Chair/Vice Chair of the Integration Joint Board is reduced from three years to two years. Currently terms of office range between one and three years. 4.5 Content in relation to Section 12 of the 2020 version of the Integration Schemes (Finance) was reviewed by the Chief Finance Officers Group. Minor changes in wording to achieve clarity and consistency were agreed and the revised text was presented to the working group with the recommendation that this be adopted within the Greater Glasgow and Clyde area, recognising there may be some minor local variations as agreed in 2020.
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4.6 Section 7 on Local Operational Delivery Arrangements has been revised in how Hosted Services are delivered. Previous iterations of all Schemes contained an annex that listed the services subject to hosting arrangements and which HSCP area was responsible for those services across the Health Board territory. This has now been removed, not only to futureproof the Schemes from any subsequent changes, but to emphasise that the Scottish Government approves the Schemes rather than specific hosting arrangements which are agreed locally. The Schemes instead now simply describe how hosting arrangement operate. 4.7 The working group has been in regular contact with the Scottish Government on processes and timescales for the revised Schemes. 4.8 The Greater Glasgow and Clyde Heath Board Finance, Planning and Performance Committee considered a similar paper to this on 3 October 2023 and granted their approval to start consultation on the Integration Schemes. 4.9 If approved by West Dunbartonshire Council the draft revised Integration Scheme will be subject to consultation with the prescribed consultees in accordance with section 46 of the Public Bodies (Joint Working) (Scotland) Act 2014. 4.10 Following the consultation exercise, the feedback received will be used to make any necessary revisions to the draft Scheme and the updated draft will be presented to Council and the Health Board for final approval. Once approved the Scheme will be presented to the Integration Joint Board for noting prior to concluding the process by seeking parliamentary approval. 5. People Implications 6.1 There are no people implications in respect of the recommendations within this report. 6. Financial and Procurement Implications 6.1 There are no financial and procurement implications in respect of the recommendations within this report. 7. Risk Analysis 7.1 Should West Dunbartonshire Council not approve the recommendations in this report the operational risk is minimal as an approved Integration Scheme remains in place. However, there is a reputational risk should this work not progress in line with legislation. 8. Equalities Impact Assessment (EIA) 8.1 An Equalities Impact Assessment is not required as the recommendations within this report do no directly impact on those with protected characteristics.
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9. Consultation 9.1 The draft revised Integration Scheme was shared with colleagues in both NHS Greater Glasgow and Clyde and West Dunbartonshire Council Legal Services for input on whether the Integration Scheme meets the statutory requirements surrounding review of Integration Schemes as laid out in the Act. Where required, the draft Scheme has been amended to accommodate the advice from both Legal Services Teams (e.g. in relation to legislative changes that impact on the functions delegated to Integration Joint Boards). 9.2 Relevant Council Officers have been consulted in the preparation of this covering report and their comments incorporated appropriately. It should be noted that both Legal Services and Finance have raised some comments in respect of the draft Integration Scheme itself. These comments will be captured and addressed as required as part of the consultation prior to the Scheme returning to Council on the 6 March 2024. 10. Strategic Assessment 10.1 The delivery of both West Dunbartonshire Council’s Strategic Plan 2022 – 2027 and West Dunbartonshire Health and Social Care Partnership’s Strategic Plan 2023 – 2026 are predicated on systems of good governance. 10.2 Consideration and ultimately approval of the Integration Scheme ensures that the key arrangements of how Health and Social Care Services are planned, delivered and performance monitored within the local partnership area. Beth Culshaw Chief Officer West Dunbartonshire Health and Social Care Partnership 4 October 2023 Person to Contact: Beth Culshaw Chief Officer West Dunbartonshire Health and Social Care Partnership Email: beth.culshaw@ggc.scot.nhs.uk Appendices: Appendix I: Revised Integration Scheme Background Papers: West Dunbartonshire Council 26 February 2023 Wards Affected: All Wards