Agenda, decisions and minutes

The Chair opened the meeting and welcomed Luan Grugeon onto the Board as a voting member and introduced Malcolm Wright (Chief Executive, NHSG). The Chair provided a number of updates for members information (1) he noted that today was the first Board meeting which would run from 10am-3:30pm; (2) he highlighted the Maximising Locality Opportunities workshops on 21 and 22 November; (3) he confirmed that all appointments had been made to the Head of Localities posts; (4) he provided an overview of regional and national meetings he had attended in his capacity as Chair of the Aberdeen City IJB; (5) he advised that Audit Scotland had recently published a report on the NHS in 2017 and encouraged members to read the report; (6) he reminded members that the IJB annual accounts had been circulated to members for information as the authority to approve the annual accounts rests with the Audit and Performance Systems Committee; (7) he noted that the Winter Plan had been presented to the Clinical and Care Governance Committee on 3 October 2017; and (8) he thanked Gill Moffat for circulating a compelling article on carers which had been published on World Mental Health Day and urged members to read the article.

The Board resolved:-

(i)            to welcome Luan Grugeon onto the Board as a voting member;

(ii)          to instruct the Clerk to circulate a link to the recently published NHS in Scotland 2017 report;

(iii)         to thank Gill Moffat for circulating the article on carers on World Mental Health Day to Board members; and

(iv)         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 by members for items on today’s agenda.

The Chair proposed that items 14 (Transformation Decisions Required), 15 (Board Development Work) and 16 (Funding to a Voluntary organisation) 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 paragraph 1 (Transformation Decisions Required) paragraphs 6 (Funding to a Voluntary Organisation) and paragraph 8 (Board Development Work) of Schedule 7(A) of the Act.

The Board had before it the minute of the Board meeting of 15 August 2017.

The Board resolved:-

To approve the minute as a correct record.

The Board reviewed any matters arising from its meeting on 15 August 2017.

In reference to item 12(i), the Chief Finance Officer explained that the Partnership was awaiting guidance from the Scottish Government on workforce planning and this would inform the Partnership’s approach and shape the report that would be presented to the Board in due course.

The Board resolved:-

To note the information provided.

The Board had before it the draft minute of the Audit and Performance Systems Committee of 21 August 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 3 October 2017 for information.

Councillor Samarai highlighted that the Committee had identified an issue relating to fire safety and the Chief Officer advised that Aberdeen City Council was in the process of assessing fire safety as part of a wider review and the Partnership would continue to monitor progress in this area and report back to the Committee or Board as required.

The Board resolved:-

(i)           to note the draft minute; and

(ii)          to note the information provided.

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

With reference to item 1 (Delegated Functions and Services), the Chief Officer provided assurance that no impact on service delivery had been felt or was anticipated due to the delay in agreeing the IJB Scheme of Delegation.

The Board resolved:-

(i)            to remove item 7 (Ethical Care Charter) from the Statement; and

(ii)          otherwise note the Statement.

The Board had before it a report by the Clerk which advised of the requirement to appoint a voting member onto the Audit and Performance Systems (APS) Committee and appoint a Chairperson to the APS Committee.

The report recommended:-

That the Board –

(a)          Appoint an NHSG voting member to the Audit and Performance Systems Committee;

(b)          Appoint an NHSG voting member as Chairperson of the Audit and Performance Systems Committee; and

(c)          Agree to review the membership of both IJB committees at the Board’s meeting in May 2018.

The Clerk recommended that to maintain the equal representation principle, the Board should appoint NHSG voting members to the vacant positions on the APS Committee.

The Vice Chair moved, seconded by the Chair that the following nominations

be agreed by the Board:-

a)        To nominate Luan Grugeon as a voting member of the Audit and Performance Systems Committee; and

b)        To nominate Rhona Atkinson as the Chairperson of the Audit and Performance Systems Committee.

The Board resolved:-

(i)            to appoint Luan Grugeon to the Audit and Performance Systems Committee;

(ii)          to appoint Rhona Atkinson as Chairperson of the Audit and Performance Systems Committee;

(iii)         to agree to review the terms of reference, membership and structure of both IJB committees at the Board meeting on 22 May 2018.

The Board had before it a report by the Clerk which proposed a meeting schedule for 2018-19 and an extension to the remaining 2017-18 meeting dates.

The report recommended:-

That the Board –

(a)          Agree to extend the meeting times for the remaining 2017-18 meeting dates from 10am-3:30pm and instruct the Clerk to resend appointments to members and officers;

(b)          Agree the IJB meeting schedule for 2018-19;

(c)          Agree to hold developmental workshop sessions on 9 January and 24 April 2018; and

(d)          Agree that meeting dates be publicised on the Partnership’s website.

The Clerk proposed to extend the length of board meetings for the current financial year from 10am-3:30pm to ensure that all IJB business and developmental sessions could be accommodated within allotted time. He also requested approval of the 2018-19 meeting schedule in which meetings would continue to be held on a 6-8 weekly cycle and confirmed that no meetings had been scheduled on public holidays or recess periods.

Councillors Cooke and Samarai commented on the cost and appropriateness of proposed catering arrangements for future Board meetings. The Board acknowledged these concerns; however a number of members highlighted factors such as disability access; effective use of Board time; and a lack of catering options in the vicinity of the Health Village as their rationale for supporting the proposed catering arrangements. In the spirit of consensus the Board agreed to approve the recommendations but review the catering arrangements on 27 March 2018.

The Board resolved

(i)            to agree to extend the meeting times for the remaining 2017-18 meeting dates from 10am-3:30pm and to instruct the Clerk to resend appointments to members and officers;

(ii)          to agree the IJB meeting schedule for 2018-19;

(iii)         to agree to hold developmental workshop sessions on 9 January and 24 April 2018;

(iv)         to agree that meeting dates be publicised on the Partnership’s website; and

(v)          to agree catering arrangements would be reviewed at the Board meeting on 27 March 2018.

Councillors Cooke and Samarai requested that their dissent with regards to resolution 10(v) be recorded in the minute

The Board had before it a report by Jess Anderson, Alan Thomson and the Clerk (Legal and Democratic Services, ACC) which reviewed IJB standing orders and recommended revisions for Board approval.

The report recommended:-

That the Board –

(a)          Approve the revisions made to IJB standing orders;

(b)          Note that the revised standing orders would take effect from the Board’s next meeting on 12 December 2017; and

(c)          Agree to review standing orders annually as per order 8(5).

The Clerk advised that it had been 18 months since the Board went live and officers from Legal and Democratic Services had reviewed standing orders to ensure they remained robust and fit for purpose and recommended a number of changes for the Board's consideration.

Thereafter there were questions and comments on (1) the definition of non-material amendments in relation to order 8(6); (2) the 48 hours notice period for urgent business meetings in relation to order 10(5); (3) the appointment of additional members to the Board as outlined in order 2(4); and (4) the list of consultees who would receive draft reports as set out in order 12.

The Board resolved:-

(i)            to approve the revisions made to IJB standing orders;

(ii)           to note that the revised standing orders would take effect from the Board’s next meeting on 12 December 2017;

(iii)         to agree to review standing orders annually as per order 8(5); and

(iv)         to request that officers review standing order 2(4) and provide an update on whether its wording was based on a requirement set out in The Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Order 2014.

The Board had before it a report by Gillian Parkin (Finance, NHS Grampian) and Jimmie Dickie (Finance, ACC) which (1) summarised the current year revenue budget performance for the services within the remit of the IJB as at Period 6; (2) advised on any areas of risk and management action relating to the revenue budget performance of the IJB services; and (3) requested approval of budget virements so that budgets were 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 action that are contained therein;

(b)          Note the work undertaken by officers to reduce the overspend position forecast in June 2017 had been offset by new budget pressures identified in the prescribing budget;

(c)          Instruct officers to review the financial position and continue to identify savings to bring the mainstream budget back to a break even position; and

(d)          Approve the budget virements indicated in Appendix E.

The Chief Finance Officer advised that the Partnership had reduced the projected overspend from £4.5m in June to £2.8m in September. He highlighted that the Partnership had established Resource Allocation and Vacancy Management Panels to review where further efficiencies could be made. Mr Stephen explained that adverse movements had been recorded in the prescribing budget particularly for mental health medicines which had recently been in short supply and this had pushed up drug prices.

Thereafter there were questions and comments on (1) savings which could be made through hosted services; (2) the level of overspend on out of authority treatments (3) the level of learning disabilities overspend and how the Partnership engages with the Council’s Education and Children’s Services Directorate to manage a young person’s transition from children’s to adult social care; (4) the impact of efficiency savings on staff and service users; (5) the level of spend taken from the transformation fund for transformational purposes; (6) the impact of off patent drugs on prescribing costs; (7) the overspend on commissioned services with specific reference to the under recovery of client and customer receipts in residential and nursing care; and (8) ongoing work being carried out by the NHS on mitigating prescribing costs.

The Board resolved:-

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

(ii)           to commend the work undertaken by officers to reduce the overspend position forecast in June 2017 had been offset by new budget pressures identified in the prescribing budget;

(iii)         to instruct officers to review the financial position and continue to identify savings to bring the mainstream budget back to a break even position;

(iv)         to approve the budget virements indicated in Appendix E;

(v)           to request a workshop session on hosted services;

(vi)         to instruct the Chief Finance Officer to present figures to the next meeting of the APS Committee on the level of spend taken  ...  view the full minutes text for item 11.

The Board had before it a report by Jillian Evans (Head of Health Intelligence, NHSG) and Sally Shaw (Head of Strategy and Transformation, ACHSCP) which provided an update on (1) The most current data in respect of Aberdeen City Health and Social Care Partnership’s (ACHSCP’s) performance against the National Core Suite of indicators; (2) Detail on progress against other high level IJB performance measures; (3) Assurances of actions to be taken to support improvement in areas of poorer performance; (4) Detail on progress in respect of implementing the Aberdeen City HSCP Performance Framework; and (5) Clear demonstration of alignment of performance to the Aberdeen City HSCP Strategic Plan 2016 – 2019.

The report recommended:-

that the Board –

(a)          Note the performance and progress of the partnership against the high level indicators of system-wide performance;

(b)          Note the information governance pressures and challenges in sharing operational and performance data within the partnership, and the efforts that are being made achieve this within data protection legislation;

(c)          Task the Head of Strategy and Transformation with reporting performance quarterly over the year; bi-annually to the IJB and bi-annually to the Audit and Performance Systems Committee; and

(d)          Request a review of the Performance Framework in response to the review of the National Core Suite of measures undertaken by Sir Harry Burns when this is published.

Sally Shaw (Head of Strategy and Transformation, ACHSCP) provided an overview of the Partnership’s performance in a number of key areas and she stressed the need to source local data to enable the Partnership to focus its efforts and compare like for like; she added that the use of Tableau software would help support this approach. Ms Shaw highlighted that performance in delayed discharges; hospital readmissions and emergency admissions were all improving and the level of unmet need for Self-Directed Support had dropped.

Thereafter there were questions and comments on (1) the availability of data relating to adult support and protection; (2) the use of the NHS’s IMatter survey as a tool to track staff engagement; (3) the functionality of Tableau software; (4) the benefits and limitations of benchmarking local performance against other areas in Scotland with vastly different demographic profiles; (5) the possibility of commissioning a survey to track the experiences of service users through the mental health journey; (6) the possible use of Spire data to support the budgeting process; (7) the role of the APS Committee in monitoring performance and the robustness of the performance management framework; and (8) concern with regard to the percentage of adults within Aberdeen City who felt safe as this figure was below the Scottish national average.

The Board resolved:-

(i)            to note the performance and progress of the partnership against the high level indicators of system-wide performance;

(ii)          to note the information governance pressures and challenges in sharing operational and performance data within the partnership, and the efforts that are being made achieve this within data protection legislation;

(iii)         to task the Head of Strategy and Transformation with  ...  view the full minutes text for item 12.

The Board had before it a report by Alison MacLeod (Lead Strategy and Performance Manager, ACHSCP) which sought IJB approval of the draft Carer’s Strategy ‘A Life Alongside Caring’ attached as an appendix as it relates to Adult Carers.   Following IJB approval, the strategy will be the subject of public consultation across our sectors, localities and stakeholders.

The report recommended:-

that the Board –

(a)          Instruct the Chief Officer to issue the draft Carers Strategy – A Life Alongside Caring for wider public consultation; and

(b)          Instruct the Chief Officer to bring the final version of theCarers Strategy – A Life Alongside Caring to the IJB on 30^th January 2018 for approval.

Alison MacLeod (Lead Strategy and Performance Manager, ACHSCP) advised that the Partnership was required to prepare a Carer’s Strategy to comply with the requirements of the Carers (Scotland) Act 2016 which would come into effect on 1 April 2018. Ms MacLeod provided an overview of the draft plan’s development and advised that the Multi-Disciplinary Steering Group would later transition into the Implementation Group and would prepare an action plan setting out funding arrangements and service delivery. She noted that the Partnership was liaising with colleagues from the Council’s Education and Children’s Service’s Directorate to develop the section on young carers and provided an overview of indicative consultative and approval requirements.

Thereafter the Board discussed whether the section on young carers should be further developed before the draft strategy was circulated for consultation.

The Board resolved:-

(i)            to defer approval of the draft Carers Strategy to allow further detail on young carers to be included within the draft strategy; and

(ii)          to request that the draft Carers Strategy be re-submitted to the Board’s next meeting on 12 December 2017.

The Board had before it a report which related to strategic decisions, set out in the overall transformation programme that had been previously agreed in principle by the IJB as key areas of change in delivering on the direction set out in the Strategic Plan.

The Board resolved:-

(i)            to request that an options appraisal be presented to a future meeting which would include options on the use of ACC and NHSG estates and digital solutions; and

(ii)          to instruct the Chief Officer to provide an update on implementation timescales at the Board’s next meeting on 12 December 2017.

The Board had before it a report by Alex Stephen (Chief Finance Officer, ACHSCP) which requested permission to tender for support to help in the development of the Board.

The Board resolved:-

(i)            to agree in principle that it would be beneficial to commission an external organisation to provide board development support to the IJB;

(ii)           to consult IJB members on their developmental needs and priorities to inform the content of a future report on Board Development; and

(iii)         to request that the aforementioned report on Board Development be presented to the Board’s next meeting on 12 December 2017.

The Board had before it a report by Alex Stephen which sought authority to fund a service provided by a voluntary organisation.

The Board resolved:-

To approve the recommendation within the exempt report.

The Board received a presentation from Bernadette Oxley (Chief Social Work Officer, ACC) on the role of the Chief Social Work Officer.

The Board resolved:-

To thank Bernadette Oxley for the informative presentation.

The Board resolved:-

To note that this presentation had been deferred.

JONATHAN PASSMORE MBE, Chairperson.