Agenda, decisions and minutes

The Chair opened the meeting and explained that he had taken over the Chair of the IJB from Councillor Ironside and thanked him for his leadership and support during the formation of the IJB. The Chair highlighted the upcoming HEART Awards and noted that being a judge for such worthy nominees had been a very humbling experience. He also advised that an IJB Information Bulletin had been circulated to Board members on 27 January 2017 which detailed additional projects and Partnership work for members’ information.

The Board resolved:-

(i)            to thank Councillor Ironside for his leadership during the establishment of the IJB and his contribution towards health and social care integration in Aberdeen City; and

(ii)          otherwise note the information provided.

Members were requested to intimate any declarations of interest.

The Board resolved:-

To note that no declarations of interest were intimated at this time.

The Chair proposed that item 14 (Mental Health Commissioning), item 15 (Bon Accord Care Update), item 16 (Transformation Programme) and item 17 (Amputee Rehab) on today’s agenda be considered with the press and public excluded.

The Board resolved:-

In terms of Section 50(A)(4) of the Local Government (Scotland) Act 1973, to exclude the press and public from the meeting during consideration of the aforementioned items of business so as to avoid disclosure of exempt information of the classes described in paragraphs 6 and 8 of Schedule 7(A) of the Act.

As per standing order 3(3) the Chair requested nominations for Vice Chairperson of the IJB from Aberdeen City Council.

The Chair nominated Councillor Ironside and this was seconded by Councillor Cameron. Having received no further nominations, the Chair advised that Councillor Ironside had been appointed as the IJB’s Vice Chairperson.

The Board resolved:-

To appoint Councillor Ironside as the IJB’s Vice Chairperson.

The Board had before it the minute of the previous Board meeting of 15 November 2016.

The Board resolved:-

To approve the minute as a correct record.

The Board had before it a statement of pending business for information.

The Board resolved:-

(i)            to remove item 5 (Draft Strategic Plan Indicative Timetable) and item 6 (Auditing and Financial Reporting) from the statement; and

(ii)          otherwise to note the statement.

The Board had before it a report by Alex Stephen (Chief Finance Officer, ACHSCP) which updated the Board on the provisional grant settlement and implications to the IJB budget resulting from announcements made on 15 December 2016. The report advised on the budget pressure facing the Board in 2017-18 and the budget savings identified by officers to close the provisional funding gap. And highlighted to the Board the position with regard to the Board’s reserves and future year budget projections along with budget risks and assumptions underpinning the provisional budget.

The report recommended:-

That the Board –

(a)       Acknowledge the implications of the Scottish Budget and Grant Settlement on the IJB’s budget;

(b)       Agree the budget savings identified in Appendix A of this report;

(c)       Agree the use of integration and change funds amounting to £3,182,000 to close the budget gap;

(d)       Agree the Bon Accord Care contract level for 2017-18 of £26,405,000 and budget assumptions noted in section 2.7;

(e)       Agree the 2017-18 provisional IJB Budget in Appendix B;

(f)        Agree the earmarking of £2.5 million of 2016-17 underspend into a risk provision and £500,000 for replacement of essential equipment; and

(g)       Request that a report be brought back to the IJB on 28 March 2017 to detail the final 2017-18 budget for the IJB, along with a proposal for approval to release additional funding for the living wage and sleepovers.

Alex Stephen spoke to the report and advised that the budget had been discussed and approved by the Executive Team and it was their objective to strike a balance between providing resource for mainstream services and supporting the Partnership’s transformation aspirations. He explained that the presentation of the budget had taken cognizance of Aberdeen City Council’s financial protocols which were based on transparency and openness. Mr Stephen highlighted that relevant colleagues from both partners had been consulted and advised that this was a provisional budget based on indicative figures. He explained that the budget was due to be considered by Aberdeen City Council and the NHS Grampian Board in February, and thereafter would be reported back to the IJB on 28 March 2017 for final approval.

Thereafter there were questions on aligning the budget with the values and risk tolerances set out in the Strategic Plan; the achievability of the savings identified; the use of transformation and change funding for transformation purposes rather than to cover variances in the mainstream budget; the impact of prescribing on the level of overspend; how much control the Partnership had over prescribing costs; the role of Public Health in sourcing efficiencies in the prescribing budget; the high cost of care packages; the need for the Partnership to maintain a fund earmarked for reserves; the Bon Accord Care budget; the replacement of essential equipment; the importance of protecting training and registration for staff; recruitment challenges; and the apprenticeship levy.

Following discussion, Councillor Young proposed

that the Board –

(1)                    Acknowledge the implications of the Scottish Budget and Grant Settlement on the IJB’s budget;  ...  view the full minutes text for item 7.

The Board had before it a report by Gillian Parkin (Finance Manager, NHS Grampian) and Jimmie Dickie (Finance Business Partner, ACC) which summarised the current year revenue budget performance for the services within the remit of the IJB at Period Nine and advised on areas of risk and management action relating to the revenue budget performance of IJB services. The report also requested approval of budget virements so that budgets are more closely aligned to anticipated income and expenditure.

The report recommended:-

that the Board –

(a)       Note the report in relation to the IJB budget and the information on areas of risk and management actions that are contained herein;

(b)       Note that the Executive Team are reviewing this position in conjunction with the 2017-18 budget and also looking for savings to bring the mainstream budget back to a break even position; and

(c)       Agree the savings identified in Appendix E.

Alex Stephen spoke to the report and advised that an adverse position of £721,000 had been recorded at December 2016 and an overspend of £1,480,000 was now projected at Year End. He explained that the level of overspend since the last meeting in November was largely due to movements in the Learning Disabilities budget.

Thereafter members discussed the Partnership’s level of influence on locum costs; and Judith Proctor (Chief Officer, ACHSCP) suggested that the Board may find it useful if further detail was provided in future finance reports on management of the Learning Disabilities budget.

The Board resolved:-

(i)           to note the report in relation to the IJB budget and the information on areas of risk and management actions that were contained therein;

(ii)          to note that the Executive Team were reviewing this position in conjunction with the 2017-18 budget and also looking for savings to bring the mainstream budget back to a break even position;

(iii)         to agree the virements identified in Appendix E; and

(iv)         to request that further detail on management of the Learning Disabilities budget be included in future finance reports.

The Board had before it a report by Bernadette Oxley (Chief Social Work Officer, ACC) that presented the CSWO Annual Report for 2015-16. The purpose of the report was to inform members of the role of the CSWO; to provide information on statutory decision making in the period; and to give a progress report on key areas of social work and social care provision within Aberdeen City.

The report recommended:-

That the Board –

(a)       Note the content of the report, as attached at Appendix 1; and

(b)       Offer comment and observations on the content.

Bernadette Oxley spoke to the report and provided an overview of the statutory responsibilities of the CSWO and its emerging role as a principal adviser to IJBs. Ms Oxley referred members to the Annual Report attached under Appendix 1 and highlighted revised guidance published by Scottish Government in Appendix 2.

Thereafter there were questions on care for older people being integrated into locality planning; and the need for an interim ‘hybrid structure’ during the implementation of the Reclaiming Social Work programme.

The Board resolved:-

(i)            to note the report; and

(ii)          to reaffirm the importance of the CSWO post to support the Partnership’s integration agenda and as a source of advice to the Board.

The Board had before it a report by Gail Woodcock (Integrated Localities Programme Manager, ACHSCP) which provided information to the IJB on the new Local Outcome Improvement Plan (LOIP) for Aberdeen; and specifically the Resilient People section of the plan.

The report recommended:-

that the Board –

(a)       Note the LOIP as approved by the Aberdeen City Community Planning Board; and

(b)       Request annual updates on progress towards delivery of the Resilient and Supported section of the LOIP.

Judith Proctor spoke to the report and advised that the IJB was a statutory partner of Community Planning Aberdeen (CPA), with particular responsibility for the People are Resilient, Included and Supported section of the LOIP. Mrs Proctor added that she was the chair of the Resilient, Included and Supported Group within the CPA governance structure.

Thereafter members discussed the involvement of the universities in CPA and their level of contribution towards the development of the LOIP. Mrs Proctor highlighted that under the refreshed CPA structure, Aberdeen University and Robert Gordon University had been invited to participate in CPA at an appropriate level, and explained that the LOIP was a living document that would be revised as and when required.

The Board resolved:-

(i)            to note the LOIP as approved by the Aberdeen City Community Planning Board; and

(ii)          to request annual updates on progress towards delivery of the Resilient and Supported section of the LOIP.

The Board had before it a report by Jillian Evans (Head of Health Intelligence, NHS Grampian) which provided an update of progress in implementing the Framework for Performance, Governance and Improvement as approved by the IJB on 29 March 2016.

The report recommended:-

that the Board –

(a)       Note the progress of implementing the Framework in meeting national requirements and local aspirations for performance, governance and improvement;

(b)       Agree the governance processes for performance oversight and exception reporting through the Audit and Performance Systems Committee;

(c)       Consider and agree the steps in securing a data sharing agreement with national Services Scotland; and

(d)       Note the requirement for continued investment in staff to support the development of the framework at all levels within the organisation.

Jillian Evans spoke to the report and explained that data had been packaged using a tiered approach to enable the Partnership to separate strategic and operational information. This would underpin the development of local indicators and enable officers to drill deeper into the data to inform decision making and support continuous improvement. Ms Evans advised that greater detail would be reported to the IJB’s committees and they would be remitted with escalating performance issues to the Board.

Thereafter there were questions on the steps required for the Partnership to be able to sign the Information Sharing Protocol with National Services Scotland; the development of metrics for complex issues such as loneliness that had been challenging to quantify; the strategic alignment of interests between CPA and the Partnership; and the National Review of Health and Social Care Targets chaired by Sir Harry Burns.

The Board resolved:-

(i)           to note the progress of implementing the Framework in meeting national requirements and local aspirations for performance, governance and improvement;

(ii)          to agree the governance processes for performance oversight and exception reporting through the Audit and Performance Systems Committee;

(iii)        to note that the Executive Team were taking steps to secure a data sharing agreement with National Services Scotland and to request an update on progress at the Board meeting on 28 March 2017; and

(iv)        to instruct the Chief Officer to report back to the Board on 28 March 2017 with an outline of resource needed to support the development of the framework at all levels within the organisation.

The Board had before it a report by Kenneth O’Brien (Service Manager, ACHSCP) which provided information on delayed discharges to support the scrutiny of the Partnership’s performance and to facilitate further discussion.

The report recommended:-

that the Board –

(a)       Note the Partnership’s current performance in relation to delayed discharges;

(b)       Note the current status and progress in relation to the Aberdeen City delayed discharges action plan; and

(c)       Request further regular updates on delayed discharge performance and actions taken to further improve performance.

Kenneth O’Brien spoke to the report advised that he was able to present a full year position on delayed discharge performance and informed the Board that since May 2016, the number of people delayed had improved by 34% and there had been a 28% reduction in the number of bed days lost. He also highlighted that in comparison to other health and social care partnerships, Aberdeen City had improved from having the second highest number of delays to the seventh highest. Mr O’Brien provided a summary of Code 100 Delays and the Partnership’s collaboration with Aberdeen Council of Voluntary Organisations (ACVO) and other partners on issues relating to power of attorney and progressing interim housing arrangements for service users with complex needs after discharge from an acute setting.

Thereafter there were questions on care home provision and care placements as reasons for standard delays; how strategic commissioning would help improve performance; the high cost of travelling to hospitals for unpaid carers and how this had led to a number of patients being delayed; and the need for the Partnership to develop improvement targets to articulate its future ambitions.

The Board resolved:-

(i)           to note the Partnership’s current performance in relation to delayed discharges and to thank officers who contributed towards this positive trend;

(ii)          to note the current status and progress in relation to the Aberdeen City delayed discharges action plan; and

(iii)         to request further regular updates on delayed discharge performance and actions taken to further improve performance, including information on improvement targets and future ambitions.

The Board had before it a report by Sarah Gibbon (Executive Assistant, ACHSCP) which outlined the planned development work for the IJB and its committees.

The report recommended:-

that the Board –

(a)       Agree the timetable of developmental sessions attached as Appendix A; and

(b)       Instruct officers to continue to update the timetable and present revised versions to future meetings of the IJB as an item for noting.

Judith Proctor spoke to the report and advised that the timetable would support individual and board development and highlighted that workshop sessions on items integral to the integration agenda such as locality planning would be arranged before a report would be submitted to the Board for decision. She noted that the timetable was a working document and would be updated as and when required by officers or at the instruction of the IJB and its committees.

Thereafter the Clerk confirmed that the Members Induction session scheduled for 15 May 2017 would be open to returning councillors and all IJB members; and Angela Scott (Chief Executive, ACC) advised that ACC had commissioned the Good Governance Institute to support its review of adult support and protection and suggested that it may be beneficial for Board members if the findings were reported to the IJB.

The Board resolved:-

(i)           to agree the timetable of developmental sessions attached as Appendix A;

(ii)          to instruct officers to continue to update the timetable and present revised versions to future meetings of the IJB as an item for noting;

(iii)         to request that the Chief Officer liaise with the Chief Executive of ACC in order to present the findings of the Good Governance Institute’s review of adult support and protection to the Board’s meeting on 28 March 2017; and

(iv)         to request that workshop sessions on the role of the CSWO and Prescribing be added to the Developmental Timetable.

The Board had before it the draft minute of the Audit and Performance Systems Committee of 10 January 2017 for information.

The Board resolved:-

(i)           to request a review of the Committee’s resolutions for item 9 in order to reflect the assurance provided within the narrative of the minute

(ii)          otherwise note the draft minute.

Professor Mike Greaves declared an interest in the following item by virtue of his membership of the Quarriers Board but chose to remain in the meeting during consideration of this item.

The Board had before it a report by Claire Wilkie (Service Manager, Mental Health and Substance Misuse, ACHSCP) which set out a commissioning plan for people with mental illness for 2017.

The Board resolved:-

To approve the recommendations contained in the exempt report together with one additional recommendation.

The Board had before it a report by Alex Stephen which updated the IJB on the work undertaken on the Bon Accord Care Budget and sought to allocate additional funds to that organisation.

The Board resolved:-

To approve the recommendations contained in the exempt report together with one additional recommendation.

The Board had before it a report by Gail Woodcock which requested approval from the IJB to incur expenditure in relation to three projects that sit within the Partnership’s Transformation Programme.

The Board resolved:-

To approve the recommendations contained in the exempt report.

The Board had before it a report by Jason Nichol (Service Manager, ACHSCP) which proposed a formal delegation of Amputee Rehabilitation services from NHS Grampian, and sought agreement that the ACHSCP host this service on behalf of the three Grampian Partnerships.

The Board resolved:-

To approve the recommendations contained in the exempt report together with one additional recommendation.

The Board Resolved:-

To postpone today’s workshop session.

JONATHAN PASSMORE MBE, Chairperson.