Agenda, decisions and minutes

The Vice Chair (hereafter referred to as the Chair) opened the meeting and explained that in the absence of Jonathan Passmore, he would assume the Chair for today’s meeting. The Chair reminded members that it had been a year since the Aberdeen City IJB went live and he remarked on the progress that had been made by the Board in that time. The Chair noted that a significant number of apologies had been received for today’s meeting and suggested that the Community Justice workshop be rearranged for a later date.

The Board resolved:-

(i)            to postpone the Community Justice workshop and instruct officers to identify an alternative date; 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 13 (Bon Accord Care) and item 14 (Review of Internal Auditors) 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 (Review of Internal Auditors) and 7 (Bon Accord Care) of Schedule 7(A) of the Act.

The Board had before it the minute of the Board meeting of 31 January 2017.

The Board resolved:-

To approve the minute as a correct record.

The Board had before it the minute of the Special Budget meeting of 7 March 2017.

The Board resolved:-

To approve the minute as a correct record.

The Board had before it the draft minute of the Audit and Performance Systems Committee of 28 February 2017 for information.

The Board resolved:-

To note the draft minute.

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

The Board resolved:-

(i)            to remove item 4 (Integrated Care Fund) from the statement; and

(ii)          otherwise to note the statement.

The Board had before it a report by Gail Woodcock (Integrated Localities Programme Manager, ACHSCP) which requested approval to incur expenditure in relation to four projects that sit within the Partnership’s Transformation Programme.

The report recommended:-

That the Board –

(a)       Approve expenditure of £1,024,340 (total for two years) in relation to the establishment of Mental Health Community Hubs, for an initial two year period;

(b)       Approve the expenditure of up to £423,498 (total for three years) relating to Enhancing the Independent Sector Contribution to Integrated Services Project through the provision of a grant to Scottish Care, subject to State Aid assessments;

(c)       Approve the expenditure of £73,775 required to continue the THInC project through to 31 March 2018, through the provision of a grant to Aberdeenshire Council, subject to State Aid assessments;

(d)       Approve the expenditure of £104,000 required to continue the Post Diagnostic Support project through to 31 March 2018, through the extension of the existing contract; and

(e)       Instruct the Chief Officer to issue the Directions attached at Appendix E and Appendix F to Aberdeen City Council and NHS Grampian respectively.

Gail Woodcock explained that the report sought approval to incur expenditure for four transformation programmes (Mental Health Community Hubs; Enhancing the Independent Sector Contribution to Integrated Services in Aberdeen City; THInC Transport Extension; and Alzheimer’s Scotland Post Diagnostic Support Service) and to issue Directions to that effect to NHS Grampian and Aberdeen City Council.

Thereafter there were questions on the level of financial support to the Mental Health Community Hubs and the multi-disciplinary remit of the Hubs; the development of outcomes to reflect the Partnership’s aspiration to release GP capacity; the level of engagement with the independent and third sectors, with particular regards to their expertise in transport provision and working with vulnerable people; and the role and remit of Scottish Care, as the umbrella body representing independent health and social care providers in Scotland.

The Board resolved:-

(i)            to approve expenditure of £1,024,340 (total for two years) in relation to the establishment of Mental Health Community Hubs, for an initial two year period;

(ii)          to approve the expenditure of up to £423,498 (total for three years) relating to Enhancing the Independent Sector Contribution to Integrated Services Project through the provision of a grant to Scottish Care, subject to State Aid assessments;

(iii)         to approve the expenditure of £73,775 required to continue the THInC project through to 31 March 2018, through the provision of a grant to Aberdeenshire Council, subject to State Aid assessments;

(iv)         to approve the expenditure of £104,000 required to continue the Post Diagnostic Support project through to 31 March 2018, through the extension of the existing contract; and

(v)          to instruct the Chief Officer to issue the Directions attached at Appendix E and Appendix F to Aberdeen City Council and NHS Grampian respectively.

The Board had before it a report by Gail Woodcock which provided information on progress towards utilising Buurtzorg principles to develop new integrated community nursing and care at home teams. The report also sought agreement for a cross sector team to visit the Netherlands to learn more about the approach in order to inform developments in Aberdeen.

The report recommended:-

that the Board –

(a)       Note the progress towards testing integrated community teams, using Buurtzorg principles, in Aberdeen; and

(b)       Approve a cross sector team to visit the Netherlands to learn more about the approach in order to inform the development of this project, at an estimated cost of £4,000, funded from the Integration and Change Fund.

Gail Woodcock spoke to the report and explained that the Buurtzorg model advocated person centred support and its aim was to enable health and social care practitioners to work collaboratively with the service user’s family and other informal networks. She noted that Buurtzorg principles aligned with locality planning and it was the Partnership’s intention to test the model in a small number of communities as a test of change prior to a full roll out across the city if outcomes in test areas were being met. Ms Woodcock also highlighted the report’s request to approve funding for officers to travel to the Netherlands to meet Buurtzorg staff on a learning visit.

Thereafter there were questions on the involvement of unpaid carers in the Buurtzorg model and the level of engagement the Partnership had had with carer organisations; proposed changes to staff structures and trade union consultation; and members scrutinised the level of funding for the learning visit to the Netherlands, to which Ms Woodcock advised that travel costs were based on tariffs that were standard for visits of this kind.

The Board resolved:-

(i)           to note the progress towards testing integrated community teams, using Buurtzorg principles, in Aberdeen; and

(ii)          to approve a cross sector team to visit the Netherlands to learn more about the approach in order to inform the development of this project, at an estimated cost of £4,000, funded from the Integration and Change Fund.

The Board had before it a report by Alison Macleod (Social Care Procurement Manager, ACC) which advised the Board on the outcome of the additional 6.4% uplift to care providers in relation to payment of the Scottish Living Wage during 2016-17; and the report sought approval for a further uplift of 2.6% during 2017-18 and for additional, individually targeted funding to be allocated to contracted organisations providing a sleepover service to enable them to meet HMRC guidelines.

The report recommended:-

That the Board –

(a)       Note the outcome of the additional 6.4% funding provided in 2016/17 to contracted providers of social care services in relation to payment of the Scottish Living Wage of £8.25 per hour;

(b)       Approves the provision of a further uplift of 2.6% funding in 2017/18 to contracted providers of social care services to allow for the increase of the Scottish Living Wage from £8.25 to £8.45 per hour from 1st April 2017.   The uplift to be paid dependant on receipt of a signed contract variation and completion of the verification questionnaire;

(c)       Approves the provision of additional, individually targeted, funding to those contracted organisations providing a sleepover service to enable them to meet HMRC guidelines of the average hourly rate for a sleepover shift being equivalent to at least the National Minimum Wage of £7.50 per hour from 1st April 2017; and

(d)       Issues a Direction to Aberdeen City Council to prepare and issue contract variationsto all appropriate contracted providers in relation to the 2.6% uplift to ensure payment of the Living Wage and to prepare and issue contract variations to providers of a sleepover service to award additional funding in relation to the payment of these at an average hourly rate equivalent to the National Minimum Wage.

Alex Stephen (Chief Finance Officer, ACHSCP) spoke to the report and explained that the report provided an update on the number of contracted care home providers that had confirmed payment of the Scottish Living Wage since the IJB approved the 6.4% uplift at its meeting on 30 August 2016. He informed the Board that of the 78 contract variations, 55 providers had responded to the review and all 55 of these providers confirmed payment of the Scottish Living Wage. In reference to sleepovers, Mr Stephen explained that in order to be compliant with a recent Her Majesty’s Revenue and Customs (HMRC) ruling, an additional £650,000 would have to be found to meet the uplift in the rate of pay from £7.20 to £7.50 per hour on an individual basis.

Thereafter there were questions on the rate of pay for sleepover staff, which from 1 April 2017 would be 95p per hour less than the Scottish Living Wage. Members also examined the merits of the working nights and sleepover systems, and discussed which system was the most effective way to deliver care through the night.

The Board resolved:-

(i)            to note the outcome of the additional 6.4% funding provided in 2016/17 to contracted providers of social care  ...  view the full minutes text for item 10.

The Board had before it a report by Laura Botea (Senior Programme Delivery Office, GGI) and Sarah Gibbon (Executive Assistant, ACHSCP) that provided an update on the implementation of the recommendations from the Good Governance Institute (GGI).

The report recommended:-

That the Board note the progress towards the implementation of the GGI recommendations, as outlined in Appendix 1.

The Chief Officer spoke to the report and highlighted progress made by the Partnership against the GGI recommendations outlined in Appendix 1. She noted that the workshops facilitated by the GGI had also contributed to the Board’s development.

Thereafter members recognised the progress made since the Go Live date and welcomed the continued external critique of the Board’s governance and risk management arrangements; and members agreed that the integration workshops facilitated by the GGI had been very useful in supporting the Board’s development. The Board also discussed the development of Carer Pathways and the establishment of the Market Facilitation Steering Group which would inform the Partnership’s approach. Further to this point, the Chief Officer highlighted the creation of the digital Ideas Hub which was accessible to colleagues across the Partnership with the aim of providing a platform to generate ideas for service improvement from the bottom-up.

The Board resolved:-

To note the progress towards the implementation of the GGI recommendations, as outlined in Appendix 1.

The Board had before it a report by the Chief Officer that sought agreement for the Partnership to participate in national measurement of improvement under integration.

The report recommended:-

that the Board –

(a)       Agree that publically available data relating to the performance of the IJB and HSCP can be used to support the MSG in measuring performance under integration;

(b)       Instructs the Chief Officer to develop trajectories for improvement and that these are considered in relation to the IJB’s own improvement plan and present these at a future meeting; and

(c)       Asks the Chief Officer to reply formally to the request setting out the IJB’s position.

The Chief Officer spoke to the report and explained that each IJB Chief Officer had received correspondence from the Scottish Government and COSLA inviting them to provide the Ministerial Strategic Group with Partnership objectives and to set out improvement trajectories and ambitions against the six key areas of performance noted below:-

1)    Unplanned admissions

2)    Occupied bed days for unscheduled care

3)    A&E performance

4)    Delayed Discharges

5)    End of life care

6)    The balance of spend across institutional and community services

The Chief Officer advised that she was seeking the approval of the Board to share relevant performance information with the Ministerial Strategic Group.

Thereafter members welcomed this development and highlighted the importance of sharing experiences and best practice. Members also highlighted that the Partnership would have to strike an appropriate balance between the attainment of objectives at national and locality levels.

The Board resolved:-

(i)           to agree that publically available data relating to the performance of the IJB and HSCP can be used to support the MSG in measuring performance under integration;

(ii)          to instruct the Chief Officer to develop trajectories for improvement and that these are considered in relation to the IJB’s own improvement plan and present these at a future meeting; and

(iii)        to ask the Chief Officer to reply formally to the request setting out the IJB’s position.

The Board had before it a report by the Clerk which sought approval to revise the 2017-18 meeting schedule to take account of the Statutory Council meeting date and to arrange an additional date to consider the IJB budget.

The report recommended:-

that the Board –

(a)       Agree the revised schedule attached as Appendix A;

(b)       Agree that the IJB Induction/Refresh session be arranged for 23 May 2017 and for the Developmental Timetable to be updated accordingly; and

(c)       Instruct the Clerk to make necessary preparations to arrange these meetings.

The Clerk suggested that the IJB meeting on 23 May 2017 should be rearranged for 6 June 2017 to take account of the later Statutory Council meeting on 17 May 2017 in which IJB voting members would be appointed. The Clerk proposed that the IJB Induction/Refresh training now be scheduled for 23 May 2017. He also recommended that an additional meeting be added to the schedule to consider the IJB budget on 6 February 2018 before submission to the annual budget meetings of Aberdeen City Council and the NHS Grampian Board as per the IJB Budget Protocol agreed by the Board at its meeting on 7 March 2017.

The Board resolved:-

(i)           to agree the revised schedule attached as Appendix A;

(ii)          to agree that the IJB Induction/Refresh session be arranged for 23 May 2017 and for the Developmental Timetable to be updated accordingly; and

(iii)         to instructthe Clerk to make necessary preparations to arrange these meetings.

Councillor Ironside was presented with a HEART Award by Professor Mike Greaves, on behalf of the Board in recognition of his Chairmanship of the IJB and his leadership over the past 18 months. In response, Councillor Ironside thanked fellow Board members, the Executive Team and all health and social care colleagues for their dedication and support. He concluded by highlighting how pleased he was with the progress that the Board and Partnership had made towards the integration of health and social care in Aberdeen City and wished members and officers well for the future.

The Board resolved:-

To recognise Councillor Len Ironside for his Chairmanship of the IJB; and his leadership and contribution towards the integration of health and social care in Aberdeen City, and to wish him well on his retirement from public life.

The Board had before it a report by Sandra Ross (Managing Director, Bon Accord Care) which presented the format, scope and strategic direction of Bon Accord Care as a provider of a range of commissioned health and social care services to older people within Aberdeen City.

The report recommended:-

That the Board note the attached report relating to Bon Accord Care.

The Board resolved:-

To note the report.

The Board had before it a report by Alex Stephen (Chief Finance Officer, ACHSCP) which set out the process for appointing an internal auditor for 2017-18.

The report recommended:-

That the Board agree that the shared internal audit service used by both Aberdeen City and Aberdeenshire Councils will provide internal audit services to the IJB.

The Board resolved:-

(i)            to agree that the shared internal audit service used by both Aberdeen City and Aberdeenshire Councils will provide internal audit services to the IJB; and

(ii)          to instruct the Clerk to liaise with counterparts in Aberdeen City and Aberdeenshire Councils and IJBs to avoid a conflict of meeting dates for 2018-19.

The Board were due to receive a presentation on Community Justice.

The Board resolved:-

To postpone the Communtiy Justice workshop and instruct officers to identify an alternative date.

COUNCILLOR LEN IRONSIDE CBE, The Chair.