Agenda, decisions and minutes

The Chair proposed that item 18 (Drugs and Alcohol Retendering), item 19 (Bon Accord Care Report) and item 20 (Transformation Progress Report) 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 1, 7, 8 and 9 of Schedule 7(A) of the Act.

The Board had before it the minute of the previous Board meeting of 30 August 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:

To note the statement.

The Board had before it a report by Alex Stephen (Chief Finance Officer, ACHSCP) which outlined the review of the Audit and Performance Systems Committee (APS) Terms of Reference which required to be reviewed on a six monthly basis.

The report recommended:-

That the Board approve the changes to the Terms of Reference as recommended by the Audit and Performance Systems Committee.

Alex Stephen spoke to the report and advised that the APS Committee had conducted the six monthly review of the Terms of Reference and recommended that item 13 be revised to delegate authority from the IJB to the APS Committee to consider and approve unaudited and audited annual accounts. He noted that this change would be in line with accounting legislation and the annual accounts would thereafter be presented to the IJB for information.

The Board resolved:

To approve the changes to the Terms of Reference as recommended by the Audit and Performance Systems Committee.

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 Six 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 on the month six position in relation to the IJB budget and the information on areas of risk and management action that was contained therein;

(b)       Agree to the virements proposed in Appendix E;

(c)       Agree the Local Enhanced Service initiative as detailed in paragraph 2.5 funded from the prescribing budget on an invest to save basis; and

(d)       Agree the direction as set out in Appendix F.

Alex Stephen spoke to the report and advised that the Partnership’s finances were stable with a favourable position of £1,199,000 reported at Period Six. He explained that the projected overspend of £931,000 at Year End was largely driven by the prescribing budget. Mr Stephen noted that the Partnership had requested GPs to review their prescribing arrangements to prevent issues like patients over ordering and stockpiling medicines to increase cost effectiveness. He advised that £500,000 of Transformation Funding had been allocated to cover the projected overspend at Year End but suggested that additional funds may need to be found to cover other outstanding variances.

Thereafter there were questions on proposed initiatives that would help GPs to reduce prescribing costs; the underspend recorded due to staff vacancies; and the  use of Transformation Funding to cover variances in the Partnership’s core budget.

The Board resolved:

(i)           to note the report on the month six position in relation to the IJB budget and the information on areas of risk and management action that was contained therein;

(ii)          to agree to the virements proposed in Appendix E;

(iii)         to agree the Local Enhanced Service initiative as detailed in paragraph 2.5 funded from the prescribing budget on an invest to save basis; and

(iv)         to agree the direction as set out in Appendix F.

The Board had before it a report by Alex Stephen which proposed a reserves policy for the consideration of the IJB.

The report recommended:-

That the Board approve the Reserves Policy.

Alex Stephen spoke to the report and explained that the Strategy had been recommended by the APS Committee at its meeting on 25 October 2016 but implementation was subject to IJB approval. He added that the Strategy provided a strong financial framework which would be populated to a greater extent in due course.

Thereafter members queried the role of the Council’s S95 Officer and NHS Grampian’s Director of Finance in the Reserve Policy’s approval process, to which Mr Stephen advised that the Integration Scheme outlined the role of the parent bodies to review the IJB’s financial arrangements and confirmed that final approval was delegated to the IJB.

The Board resolved:

To approve the Reserves Policy.

The Board had before it a report by Jillian Evans (Head of Health Intelligence, NHS Grampian) and Kevin Toshney (Acting Head of Strategy and Transformation, ACHSCP) which provided a progress report on the development of the Partnership’s performance management framework, and to report on the Partnership’s performance to date against the national outcomes and their suite of national and local indicators and to outline the improvement activity that had been taken forward.

The report recommended:-

that the Board –

(a)       Note the endorsement of this paper by the APS Committee;

(b)       Note the progress that had been made to date in developing the Partnership’s performance management framework;

(c)       Instruct the Chief Officer to make the necessary arrangements for the completed performance management framework to be presented to the IJB at its next meeting;

(d)       Note the Partnership’s performance against the national outcomes and the associated suite of national and local indicators; and

(e)       Instruct the Chief Officer to make the necessary arrangements for future performance monitoring reports to be accompanied by an improvement plan.

Kevin Toshney spoke to the report and advised that the emerging performance management framework would enhance the Partnership’s intelligence capacity and provide assurance to the IJB that risks were being identified, mitigated and managed. He explained that the framework would allow the IJB to monitor performance against the National Health and Wellbeing Outcomes and the Partnership’s bespoke local indicators. Mr Toshney highlighted that delayed discharge performance had continued to improve but the extent of progress varied by locality. He advised that the framework would be further developed to identify unmet social care need, capacity issues in the social care market and progress in relation to hosted service performance. He also noted that improvement plans would be developed to demonstrate how the Partnership would action recommendations made in the Social Work in Scotland: Audit Scotland report and the Joint Inspection of Services for Older People report and these plans would be presented to the Board in due course.

Thereafter there were questions on the low survey response rates and the representativeness of the data; the APS Committee’s scrutiny role to provide assurance to the IJB; the development of data to help support operational performance and the role of Locality Leadership Groups in this process; the review of the National Health and Wellbeing Outcomes led by Sir Harry Burns; and progress in relation to the Partnership’s delayed discharge performance.

The Board resolved:

(i)            to note the endorsement of this paper by the APS Committee;

(ii)          to note the progress that had been made to date in developing the Partnership’s performance management framework;

(iii)         to instruct the Chief Officer to make the necessary arrangements for the completed performance management framework to be presented to the IJB at its next meeting;

(iv)         to note the Partnership’s performance against the national outcomes and the associated suite of national and local indicators;

(v)          to instruct the Chief Officer to make the necessary arrangements for future performance monitoring reports to be accompanied by  ...  view the full minutes text for item 7.

The Board had before it a report by Kevin Toshney and Gail Woodcock (Integrated Localities Programme Manager, ACHSCP) which provided an overview of the strategic planning activities that were being progressed following the publication of the Strategic Plan and to give an indicative timetable in relation to these.

The report recommended:-

that the Board –

(a)       Note the emerging development of the Strategy and Transformation team;

(b)       Agree the prioritisation of the required planning activities;

(c)       Direct the Chief Officer to ensure that the completed plans were brought to the Board at the appropriate time for discussion and approval;

(d)       Agree that the completed ‘Resilient, Supported and Included’ section of the Local Outcomes Improvement Plan be brought to the Board at a future date for noting; and

(e)       Agree that the completed Community Justice Outcomes Improvement Plan be presented to the Board at a future date for noting.

Kevin Toshney spoke to the report and explained that the timeline followed on from the publication of the Strategic Plan in April 2016 and provided an outline of the management and team structures that had emerged since the go live date. He advised that further detail on delegated functions would be added in due course and that the Partnership would also need to develop a Commissioning Plan for new models of care; a Carers Strategy; and a Learning Disability Strategy. Mr Toshney further noted that the Strategic Plan required to be reviewed every three years and advised that the Strategic Planning Group would conduct a light touch review in 2017 ahead of a more comprehensive review in 2018.

Thereafter there were questions on the Carers Strategy Steering Group and the launch date of the Carers Strategy; how the Partnership would meet the National Health and Wellbeing Outcomes; the development of Community Planning Aberdeen’s (CPA) Local Outcome Improvement Plan (LOIP) and the Partnership’s contribution to its production; and the Partnership’s level of accountability with regards to the delivery of LOIP and community justice outcomes.

The Board resolved:

(i)           to note the emerging development of the Strategy and Transformation team;

(ii)          to agree the prioritisation of the required planning activities;

(iii)        to direct the Chief Officer to ensure that the completed plans were brought to the Board at the appropriate time for discussion and approval;

(iv)        to agree that the completed ‘Resilient, Supported and Included’ section of the Local Outcomes Improvement Plan be brought to the Board at a future date for noting;

(v)          to request a workshop on community justice; and

(vi)        to agree that the completed Community Justice Outcomes Improvement Plan be presented to the Board at a future date for noting.

The Board had before it a report by Christina Cameron (NHS Grampian) which provided an update on the shared process that had been undertaken for winter (surge) planning for health and social care services in the Grampian area for winter 2016-17. It set out the steps taken to prepare for winter across community and acute settings and how these efforts had been co-ordinated.

The report recommended:-

that the Board –

(a)       Note the update on the winter planning process; and

(b)       Note the approved Grampian Winter (Surge) Plan 2016-17.

Judith Proctor (Chief Officer, ACHSCP) spoke to the report and advised that the Partnership had contributed to the planning and testing of the Grampian-wide plan and she summarised the table top testing exercises undertaken to provide assurance on the resilience of the services that cut across the Partnership; NHS Grampian and the acute sector. She noted that the plan had been approved by the NHS Grampian Board on 3 November 2016.

Thereafter there were questions on the level of additional funding allocated to NHS Boards across Scotland; and members recognised that the Partnership and its partners had won an award in response to last winter’s flooding. 

The Board resolved:

(i)           to note the update on the winter planning process;

(ii)          to note the approved Grampian Winter (Surge) Plan 2016-17; and

(iii)         to request further information for comparative purposes on the level of additional funding allocated by the Scottish Government to all NHS Boards.

The Board had before it a report by Lorraine McKenna (Business Manager, ACHSCP) which reported progress on the civil contingency response capability of the Partnership to an emergency situation. The report presented a three year civil contingencies plan which outlined the pathway to an integrated health and social care response to an emergency situation and informed the IJB of the requirements of the Scottish Government in relation to their recently released Standards for Organisational Resilience.

The report recommended:-

that the Board –

(a)       Note the improved response capabilities of the Partnership to emergency situations;

(b)       Continue to support the ongoing development of an integrated system for responding to emergency situations; and

(c)       Endorse the three year civil contingencies plan as presented.

Lorraine McKenna spoke to the report and explained that a joint short life working group had developed a common approach across all Grampian IJBs in relation to contingency planning. She noted that the Civil Contingencies Plan had incorporated the working group’s ten recommendations and the Scottish Government’s resilience requirements. Ms McKenna then provided the Board with an outline of the plan’s training requirements; control centre operations; processes for the integration of systems; and senior manager on call (SMOC) arrangements. She informed the Board that individual GP practices would be responsible for preparing their own business continuity plans which the Partnership was happy to support but had limited input over quality control or review timescales. She added that a Joint Resilience Group would be established which may require the relocation of services and staff and an options appraisal had been developed to review these proposals.

Thereafter there were questions on the duplication of services; the challenges of transitioning to the integrated business continuity plan; and how the Partnership could engage with GP practices to encourage and support the refresh of their individual business continuity plans.

The Board resolved:

(i)            to note the improved response capabilities of the Partnership to emergency situations;

(ii)          to continue to support the ongoing development of an integrated system for responding to emergency situations;

(iii)         to endorse the three year civil contingencies plan as presented; and

(iv)         to request that officers from the Partnership liaise with primary care colleagues and the Clinical Leadership Group to promote and support the refresh of GP business continuity plans.

The Board had before it a report by Gail Woodcock which brought to the attention of the IJB the Engagement, Empowerment and Participation Strategy that had been developed by Community Planning Aberdeen partners and sought agreement that the strategy would be adopted by the Partnership.

The report recommended:-

That the Board adopt the Community Planning Aberdeen Engagement, Empowerment and Participation Strategy as the Partnership’s engagement and participation strategy as identified within the Integration Scheme.

Gail Woodcock spoke to the report and advised that the development of an engagement strategy was a requirement of the Integration Scheme and the Partnership had co-produced the document with Community Planning Aberdeen (CPA). She explained that the Strategy aligned with the Partnership’s vision and strategic priorities but informed members that if the Strategy was approved today it may be subject to minor modification as it was due to be considered at the next CPA Board meeting on 12 December 2016.

Thereafter there were questions on the consultation process and members suggested that holding more meetings in the evenings may generate a greater number and more representative response rate from community partners and stakeholders. Members also highlighted that the Strategy before the Board had not included any veteran organisations which the Board had an obligation to engage with through the Armed Forces Covenant. Ms Woodcock assured members that this issue had been identified and addressed within the revised Strategy which now included the North East Scotland Disabled Veterans Association and this version would be presented to the CPA Board in December.

The Board resolved:

To adopt the Community Planning Aberdeen Empowerment, Engagement and Participation Strategy as the Partnership’s engagement and participation strategy as identified within the Integration Scheme.

The Board had before it a report by Sarah Gibbon (Executive Assistant, ACHSCP) which asked the Board to consider the Social Work in Scotland prepared by Audit Scotland and to highlight key areas and recommendations relevant for the IJB.

The report recommended:-

that the Board –

(a)       Note the content of the Audit Scotland ‘Social Work in Scotland’ report and the ongoing work within the IJB relevant to the recommendations raised;

(b)       Note the Partnership’s response to the recommendations in the report;

(c)       Agree to a development workshop on the role of the Chief Social Work Officer in relation to the IJB.

Judith Proctor spoke to the report and advised that the Audit Scotland report had reviewed adult social care arrangements within the new integration environment and outlined a number of issues facing the sector including demographic change and recruitment challenges. Mrs Proctor explained that the report had reviewed the governance and scrutiny arrangements of IJBs across Scotland and focussed on the improvement of service delivery; workforce planning; and recognised that the Chief Social Work Officer’s (CSWO) role had changed significantly in recent years and that the CSWO’s remit and responsibilities should be reviewed by boards as a priority. Graeme Simpson (Children’s Services Manager, ACC) added that the report would be submitted to the Council’s Education and Children’s Services Committee for information on 17 November 2016.

Thereafter there were questions on the remit of the CSWO; and the level of engagement between the Scottish Government and the Scottish Local Government Partnership which represented Aberdeen City Council.

The Board resolved:

(i)        to note the content of the Audit Scotland ‘Social Work in Scotland’ report and the ongoing work within the IJB relevant to the recommendations raised;

(ii)    to note the Partnership’s response to the recommendations in the report;

(iii)    to agree to a development workshop on the role of the Chief Social Work Officer in relation to the IJB.

The Board had before the minute of the Audit and Performance Systems Committee of 11 August 2016 for information.

The Board resolved:

 To note the minute.

The Board had before it the draft minute of the Audit and Performance Systems Committee of 25 October 2016 for information.

The Board resolved:

To note the draft minute.

The Board had before it the minute of the Clinical and Care Governance Committee of 16 August 2016 for information.

The Board resolved:

To note the minute.

The Board had before it the draft minute of the Clinical and Care Governance Committee of 1 November 2016 for information.

The Board resolved:

To note the draft minute.

The Board had before it the Corporate Risk Register for information.

The Board resolved:

To note the Corporate Risk Register.

The Board had before it a report by Claire Wilkie (Service Manager, Mental Health and Substance Misuse, ACHSCP) and Simon Rayner (Development Manager, Substance Misuse Service) which set out a proposed approach to re-tender specialist Drug and Alcohol Services and sought approval to re-tender these services and award contracts following the completion of the tender process.

The Board resolved:-

To approve the recommendations contained within 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 Bon Accord Care budget funding.

The report recommended:-

that the Board –

(a)       Note the work undertaken so far;

(b)       Agree that the amount outlined in the report be vired to the Bon Accord Care budget from the Central Living Wage/inflationary uplift budget line to cover the additional national insurance costs being experienced by Bon Accord Care;

(c)       Note the deficit on the Bon Accord Care budget and the actions being taken by officers to reduce this deficit; and

(d)       Instruct officers to bring a report back to the IJB on 31 January 2017 updating the Board on the financial position, strategic plan and other work being undertaken in relation to Bon Accord Care.

The Board resolved:-

(i)           to note the work undertaken so far;

(ii)          to agree that the amount outlined in the report be vired to the Bon Accord Care budget from the Central Living Wage/inflationary uplift budget line to cover the additional national insurance costs being experienced by Bon Accord Care;

(iii)         to note the deficit on the Bon Accord Care budget and the actions being taken by officers to reduce this deficit; and

(iv)         to instruct officers to bring a report back to the IJB on 31 January 2017 updating the Board on the financial position, strategic plan and other work being undertaken in relation to Bon Accord Care.

The Board had before it a report by Gail Woodcock which provided an update on the progress of the Transformation Programme.

The report recommended:-

that the Board –

(a)       Note the ongoing process and progress in developing and delivering the transformational programme;

(b)       Note that a paper would be developed for considering by the IJB in respect of the requirement to issue directions to ACC and NHSG in respect of areas of transformation;

(c)       Note the draft directions to ACC and NHSG;

(d)       Approve expenditure in relation to the procurement of Integrated Team Design Support in line with the Council’s procurement regulations; and

(e)       Approve the provision of a grant to Cornerstone to support their Buurtzorg Transformation Programme.

The Board resolved:-

(i)           to note the ongoing process and progress in developing and delivering the transformational programme;

(ii)          to note that a paper would be developed for considering by the IJB in respect of the requirement to issue directions to ACC and NHSG in respect of areas of transformation;

(iii)         to note the draft directions to ACC and NHSG;

(iv)         to approve expenditure in relation to the procurement of Integrated Team Design Support in line with the Council’s procurement regulations;

(v)          to approve the provision of the grant outlined in the report to Cornerstone to support the Buurtzorg Transformation Programme;

(vi)         to request further detail on the level of Scottish Government and other agency resource allocated to the IJB to support the implementation of Buurtzorg transformational principles; and

(vii)       to request that officers provide further information to third and independent sector colleagues on the criteria and process for accessing transformation funding.

Board members then received a presentation from on Alex Stephen on the IJB’s financial strategy.

The Board resolved:

To thank Alex Stephen for the informative presentation.

COUNCILLOR LEN IRONSIDE CBE, Chairperson.