Agenda, decisions and minutes

Following the Board’s observation of a minute’s silence in remembrance of those who lost their lives and all others affected by the attacks in London on 3 June 2017, the Chair opened the meeting and welcomed Councillor Sarah Duncan onto the Board as the Vice Chairperson and also welcomed Councillors Cooke, Donnelly and Samarai onto the Board. The Chair announced that the Partnership had recently made a number of appointments and highlighted the appointment of Sally Shaw as Head of Strategy and Transformation and the appointments of Lynn Morrison and Lorraine McKenna as Heads of Localities. He noted that a recruitment process was ongoing to make appointments to the two remaining Head of Locality posts.

The Board resolved:-

(i)            to welcome Councillor Duncan onto the Board as the IJB’s Vice Chairperson;

(ii)          to welcome Councillors Cooke, Donnelly and Samarai onto the Board as voting members;

(iii)         to congratulate Sally Shaw on her appointment as the Head of Strategy and Transformation;

(iv)         to congratulate Lynn Morrison and Lorraine McKenna on their appointments as Heads of Localities; and

(v)          otherwise note the information provided.

Professor Greaves declared an interest for agenda item 13 (Care at Home Commissioning) due to his membership of the Quarriers Board. Kenneth Simpson declared an interest for agenda items 10 (Transformation Programme) and 13 (Care at Home Commissioning) as he was the Chairperson of the Aberdeen Council of Voluntary Organisations (ACVO).

The Board resolved:-

To note the declarations of interest intimated by Professor Greaves for agenda item 13 and by Kenneth Simpson for agenda items 10 and 13.

The Chair proposed that item 13 (Care at Home Commissioning) and item 14 (Northfield/Mastrick Locality) 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 8 (Commissioning of Care at Home Services) and 7 (Northfield/Mastrick Locality) of Schedule 7(A) of the Act.

The Board had before it the minute of the Board meeting of 28 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 11 April 2017 for information.

The Board resolved:-

To note the draft minute.

The Board had before it the draft minute of the Clinical and Care Governance Committee of 14 March 2017 for information.

The Board resolved:-

To note the draft minute.

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

With reference to item 10 (Living Wage Monitoring Arrangements) the Board discussed whether this should remain on the Statement and took the view that it was appropriate to remove it as additional monitoring arrangements would be put in place through reporting to the Audit and Performance Systems Committee and an implementation update would be included within the Ethical Care Charter annual performance report.

The Board resolved:-

(i)            to remove item 8 (Good Governance Institute Implementation Plan) from the Statement;

(ii)          to remove item 10 (Living Wage Monitoring Arrangements) from the Statement but to note that monitoring arrangements would be put in place which would include reporting to the Audit and Performance Systems Committee and an update on living wage implementation would be included within the Ethical Care Charter annual performance report; and

(iii)         otherwise note the Statement.

The Board had before it a report by the Clerk which advised the Board on the requirement to appoint committee members and to appoint a Chairperson to the Clinical and Care Governance Committee.

The report recommended:-

That the Board –

(a)       Appoint two ACC voting members to the Audit and Performance Systems Committee;

(b)       Appoint two ACC voting members to the Clinical and Care Governance Committee;

(c)       Appoint an ACC voting member as Chairperson of the Clinical and Care Governance Committee; and

(d)       Note the IJB meeting schedule for 2017-18.

The Vice Chair moved, seconded by Rhona Atkinson that the following nominations be agreed by the Board:-

a)            To nominate Councillors Cooke and Duncan as voting members of the Audit and Performance Systems Committee;

b)            To nominate Councillors Donnelly and Samarai as voting members of the Clinical and Care Governance Committee;

c)            To nominate Councillor Donnelly as Chairperson of the Clinical and Care Governance Committee; and

d)            To reaffirm Professor Greaves’ Chairmanship of the Audit and Performance Systems Committee.

The Board resolved:-

(i)            to appoint Councillors Cooke and Duncan as voting members of the Audit and Performance Systems Committee;

(ii)          to appoint Councillors Donnelly and Samarai as voting members of the Clinical and Care Governance Committee;

(iii)         to appoint Councillor Donnelly as Chairperson of the Clinical and Care Governance Committee;

(iv)         to reaffirm Professor Greaves’ Chairmanship of the Audit and Performance Systems Committee; and

(v)          to note the IJB meeting schedule for 2017-18.

The Board had before it a report by Kevin Toshney (Acting Head of Strategy and Transformation, ACHSCP) that presented the draft content of the Partnership’s Annual Performance Report of its first year of operation to the Board for approval.

The report recommended:-

that the Board –

(a)       Approve the annual performance report;

(b)       Agree that the report be distributed widely, as according to the communications plan outlined in Appendix A;

(c)       Instruct the Chief Officer to provide copies of the report to the IJB’s partner organisations, Aberdeen City Council and NHS Grampian.

The Chief Officer advised that the report provided information on the Partnership’s performance against priorities set out in the Strategic Plan as well as the nine National Health and Wellbeing Outcomes during its first year of operation. She highlighted that an improvement plan had been included to track progress made thus far and to outline areas in need of further improvement. She explained that an executive summary was planned and members still had an opportunity to shape its development as it was in draft form. She added that the report’s formatting would be adjusted to make it as easy to read and accessible to the public as possible and a communication plan was being drafted to support this objective.

The Chair highlighted that the report was ambitious and captured the Partnership’s achievements over the course of its first year but also outlined the scale of the challenges it would encounter during the integration process.

Thereafter there were questions on community mental health funding and the proportion delegated to the IJB; the level of Self-Directed Support uptake; and Partnership performance with regards to the number of sickness days lost per employee.

The Board resolved:-

(i)            to approve the annual performance report;

(ii)          to agree that the report be distributed widely, as according to the communications plan outlined in Appendix A;

(iii)         to delegate authority to the Chief Officer to make minor revisions to the report in consultation with the Chair and Vice Chair of the IJB; and

(iv)         to instruct the Chief Officer to provide copies of the report to the IJB’s partner organisations, Aberdeen City Council and NHS Grampian.

The Board had before it a report by Kenneth O’Brien (Service Manager, ACHSCP) which provided an update on delayed discharge performance to support scrutiny and facilitate further discussion.

The report recommended:-

That the Board –

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

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

(c)       Consider the frequency and detail they require of future delayed discharge reporting, given the progress to date.

Kenneth O’Brien advised that the Partnership’s delayed discharge performance continued to improve with a 38% reduction in the number of individuals delayed and a 42% decrease in the number of bed days lost in comparison to the same period last year. Following this, Mr O’Brien cautioned members that performance may be steadier this year in comparison to the rapid improvements recorded during 2016.

With regards to Aberdeen City’s performance in comparison to other Partnership areas per 100,000 population, he noted that Aberdeen City was very close to the national average. And in terms of Code 100 delays which cover more complex client groups, he explained that the volume of individuals delayed may increase in the short term due to an ongoing review at Royal Cornhill Hospital and an NHS statutory review of DL-2015 which refers to hospital based complex clinical care.

Mr O’Brien also highlighted the Delayed Discharge Action Plan and in particular the development of the draft Grampian-wide Choice Policy which was currently out for consultation and aimed to standardise care home, interim and intermediate discharge flow out of hospital sites across Grampian.

Thereafter there were questions on Partnership projections for a slower rate of delayed discharge improvement during 2017/18 in comparison to the previous year; the challenges of undertaking transformational change and the development of new paradigms such as locality planning; steps taken by the Partnership to learn from best practice; initiatives developed by the Partnership which could be rolled out in the short term to improve delayed discharge performance; the role and remit of the Delayed Discharge Group; the involvement of unpaid carers in tackling delays and how awareness could be raised amongst health and social care professionals in addition to the public wider; and the development of the draft Grampian-wide Choice Policy.

The Board resolved:-

(i)           to commend officers for the recent improvement in delayed discharge performance and to reaffirm the Board’s aspiration to better the Scottish national average in terms of delayed discharge performance;

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

(iii)         to note that regular updates on delayed discharge performance would be presented to the Clinical and Care Governance Committee and to request progress updates to the IJB on a bi-annual basis.

Kenneth Simpson declared an interest in the following item as outlined in item 2 of this minute and chose to remain in the meeting during consideration of this item.

The Board had before it a report by Gail Woodcock (Integrated Localities Programme Manager, ACHSCP) which requested approval for projects which sit within the Partnership’s Transformation Programme.

The report recommended:-

That the Board –

(a)          Approve expenditure of £2,219,000 in relation to the establishment of a Hospital at Home Service;

(b)          Approve expenditure of up to £243,130 (total for two years) relating to enhancing the Third Sector Contribution to Integrated Services Project through the provision of a grant to ACVO, subject to State Aid assessments;

(c)          Approve expenditure of £284,700 (over four years) required for the District Nurse Training project;

(d)          Approve expenditure of £296,000 (over two years) for the Enhanced Pharmacy Support project;

(e)          Approve expenditure of £1,121,378 (over two years) in support of the Testing Buurtzorg Principles in Neighbourhood Teams project;

(f)           Note that a robust business case process is in place and that each project will have a clear business case which sets out key milestones for delivery benefits realisation and performance metrics; and

(g)          Instruct the Chief Officer to issue Directions attached at Appendix F-K to Aberdeen City Council and NHS Grampian as appropriate once the full business case for each project has been approved by the Executive Programme Board and append the business cases with each Direction.

The Chief Officer explained that the individual projects outlined in the report would support the Board’s strategic ambitions and if so agreed, the Board would be required to set Directions to partner organisations to deliver these projects.

The Chair reminded members that the strategic objectives had been agreed in principle and the Board was being asked to approve the use of resource for individual projects which would support these strategic objectives.

Gail Woodcock summarised the five projects set out within the report and advised that if the Board agreed to incur expenditure, detailed business cases would be developed and these would be submitted to the Executive Programme Board for scrutiny and approval. She noted that the Programme Board had been established to support the development and delivery of the Partnership’s Transformation Programme.

Thereafter there were questions on district nursing succession planning; the Buurtzorg Model; affordable housing for key workers; the development of indicators during the business planning process to monitor performance and delivery; the impact on funding levels for acute services as a result of systemic change; the involvement of service users during the consultation process; the use of Integrated Care and Transformation Funding to support the delivery of the projects; and the role of the Audit and Performance Systems Committee to provide assurance to the Board on project governance and implementation.

The Board resolved:-

(i)            to approve expenditure of £2,219,000 in relation to the establishment of a Hospital at Home Service;

(ii)           to approve expenditure of up to £243,130 (total for two years) relating to enhancing the Third Sector Contribution to Integrated Services Project through the provision of a grant to ACVO, subject to State Aid assessments;

(iii)         to approve expenditure of £284,700 (over four years) required  ...  view the full minutes text for item 11.

The Board had before it a report by Dorothy Askew (Planning and Development Manager, ACHSCP) which sought approval to develop an interim housing option for people who have low level support needs and are delayed in hospital awaiting housing adaptation or rehousing.

The report recommended:-

that the Board –

(a)       Approve the proposal to develop an interim housing option as detailed within the report; and

(b)       Approve the Direction attached as Appendix A to Aberdeen City Council in relation to expenditure required to deliver this project.

Dorothy Askew advised members that the report proposed the adaptation of two fully furnished, fully serviced properties to meet a range of needs and alleviate system pressures. She noted that the properties would be let as temporary accommodation for between 12-20 weeks and clients would be asked to enter into an occupancy agreement. Mrs Askew explained that the volume of housing delays had been historically low but noted that the length of delays had been significantly longer at times. She confirmed that the Council’s Communities, Housing and Infrastructure Directorate would manage these properties and performance information in relation to delayed discharges would be reported to the Partnership’s Delayed Discharge Group.

Thereafter there were questions on the number of payment methods open to clients to enable them to access these properties; the role of occupational therapists in identifying the two properties; and the existing arrangements in place at intermediate care facilities such as Clashieknowe.

The Board resolved:-

(i)            to approve the proposal to develop an interim housing option as detailed within the report; and

(ii)          to approve the Direction attached as Appendix A to Aberdeen City Council in relation to expenditure required to deliver this project.

The Board had before it a report by Carol Simmers (Planning and Development Manager, ACHSCP) which sought approval apply the 2.8% uplift of funding to contracted providers of social care services in relation to adult care staff extends to existing Direct Payment recipients of all Adult Social Care client groups who commission services from Personal Assistants, contracted providers and off-framework providers through Self-directed Support Options 1 and 2. The report also sought approval to proceed with applying the 2.8% rate increase from 1^st April 2017 across all Option 1 and 2 packages across adult service areas.

The report recommended:-

that the Board –

(a)       Note the 2017-18 cost of the Scottish Living Wage implementation is an estimated £120,000 in respect of Self-Directed Support options 1 and 2;

(b)       Approve the 2.8% uplift to Adult Social Care SDS packages awarded under options 1 and 2 where a personal assistant is employed from 1 April 2017 at a cost of £120,000 to allow personal assistants to receive the Scottish Living Wage of £8.45 per hour;

(c)       Approve that if the additional uplift payments should they be applied and not passed onto personal assistants, the ACHSCP reserve the right to retract the offer of the uplift to the supported person. This will be formally recorded in written communication provided to the supported person when informing them of agreed uplift in rates; and

(d)       Approve the Direction to Aberdeen City Council contained in appendix 1.

Alex Stephen (Chief Finance Officer, ACHSCP) referred members to the Board’s decision on 28 March 2017 to approve a 2.8% living wage uplift for contracted providers of social care services and explained that on reflection the report should have explicitly referenced Self-Directed Support (SDS) Personal Assistants and today’s report had been prepared to ensure these colleagues received the living wage. Mr Stephen outlined the steps the Partnership would take to communicate this decision to clients and social care agencies and the process for monitoring if clients had been using the additional funds for its stated purpose, including bi-annual financial checks to monitor compliance.

Thereafter the Board expressed concern that clients may not pass on additional SDS funding to pay their personal assistants the living wage and discussed options available to the Partnership to challenge non-compliance as well as risks to the Partnership and clients if this practice were to take place.

The Board resolved:-

(i)            to note the 2017-18 cost of the Scottish Living Wage implementation is an estimated £120,000 in respect of Self-Directed Support options 1 and 2;

(ii)          to approve the 2.8% uplift to Adult Social Care SDS packages awarded under options 1 and 2 where a personal assistant is employed from 1 April 2017 at a cost of £120,000 to allow personal assistants to receive the Scottish Living Wage of £8.45 per hour;

(iii)         to approve that if the additional uplift payments should they be applied and not passed onto personal assistants, the ACHSCP reserve the right to retract the offer of the uplift to  ...  view the full minutes text for item 13.

Professor Mike Greaves and Kenneth Simpson declared an interest in the following item as outlined in item 2 of this minute and chose to remain in the meeting during consideration of this item.

The Board had before it a report by Kevin Toshney which outlined a business case for developing a Care at Home framework across different client groups by, in the first instance, retendering the provision of care at home services for older people.

The Board resolved:-

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

The Board had before it a report by Shona Smith (Lead Officer – Primary Care Modernisation, ACHSCP) which provided an update to the Board on the negotiation process with Denburn Medical Practice and to note the package of financial support to ensure practice viability.

The Board resolved:-

To note the proposed package of financial support for Aurora Medical Practice in relation to Northfield Practice.

The Chief Officer provided a verbal update to the Board on recent developments and proposed future steps with regards to the Kingsmead Care Home.

The Board resolved:-

To note the verbal update.

The Board then broke out for a workshop session on Transformation Programme and Priorities presented by the Chief Officer

The Board resolved:-

To thank the Chief Officer for the informative presentation.

JONATHAN PASSMORE MBE, Chairperson.