Agenda, decisions and minutes

The Vice Chair (hereafter referred to as the Chair) opened the meeting and advised that Jonathan Passmore had sent his apologies and she would chair today’s meeting. The Chair welcomed Liv Cockburn onto the Board as the Third Sector Representative and introduced Amy Anderson who was substituting for Jonathan Passmore. Thereafter the Chair announced that the Partnership had awarded the Link Workers contract to the Scottish Association for Mental Health (SAMH) and that two Integrated Neighbourhood Care Aberdeen (INCA) teams had started work in both Cults and Cove.

The Board resolved:-

(i)            to welcome Liv Cockburn onto the Board as the Third Sector Representative; and

(ii)          otherwise note the information provided.

Members were requested to intimate any declarations of interest.

Luan Grugeon declared an interest for agenda item 13 (Strategic Commissioning) by virtue of her position as the Chief Executive of Alcohol and Drugs Action and would withdraw from the meeting during consideration of this item.

The Board resolved:-

To note the declaration of interest intimated by Luan Grugeon for agenda item 13.

The Chair proposed that items 16 (Board Development), 17 (Learning Disability Commissioning), 18 (Mental Health Commissioning) and 19 (Exempt Appendices) 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 8 of Schedule 7(A) of the Act.

The Board had before it the minute of the Board meeting of 12 December 2017.

The Board resolved:-

To approve the minute as a correct record.

The Chair asked if there were any matters arising from the meeting of 12 December 2017.

The Board resolved:-

To note there were no matters arising.

The Board had before it the draft minute of the Clinical and Care Governance Committee of 9 January 2018 for information.

In reference to item 2(iv), Councillor Samarai highlighted her concern about the lack of progress in relation to fire safety certificates, to which the Chief Officer advised that an update would be provided at the next Clinical and Care Governance Committee.

The Board resolved:-

(i)            with reference to item 2(iv), to note that a report would be presented to the next Clinical and Care Governance Committee on fire safety, outstanding landlord actions and the provision of assurance to Committee on registrations and contracts; and

(ii)           otherwise note the draft minute.

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

The Board resolved:-

(i)            to remove items 2 (Performance Assurance Framework), 3 (Locality Planning) and 4 (Clinical and Care Governance Framework) from the Business Statement; and

(ii)          otherwise note the Statement.

The Board had before it a report by Jenny Gordon (Public Health Dietician, ACHSCP) and Linda Smith (Public Health and Wellbeing Lead, ACHSCP) which (1) asked the IJB to endorse the enclosed response to the Scottish Government’s consultation document for diet, activity and healthy weight; (2) provided an opportunity for the IJB to further comment on the consultation response; and (3) invited the IJB to consider its role in providing leadership and advocating for a range of measures to prevent, reduce and support he numbers of people who are overweight and obese in our population.

The report recommended:-

That the Board –

(a)          Agree the consultation response in Appendix A, and instruct the Chief Officer to submit the response to the Scottish Government by the deadline of 31 January 2018;

(b)          Instruct the Chief Officer to prepare an additional paper to be presented to the IJB in early 2018 to consider the Food Charter for the SFCPA; and

(c)          Commit to the leadership that is required to achieve the range of actions to address overweight and obesity.

Jenny Gordon and Linda Smith advised that the consultation was in response to the Scottish Government’s draft Strategy prepared in November 2017 which aimed to change Scotland’s food culture and address issues such as food poverty, access to healthy food, engagement with the food and drink industry and how to support overweight and obese people.

Thereafter there were questions and comments on (1) the branding and labelling of food and drink products; (2) the importance of protecting artisan products such as Cheese which was made in the North East and economically benefited the region; (3) the role of Public Health in promoting prevention strategies and early intervention to tackle these issues and the importance of alignment with the Integrated Children’s Services Plan; and (4) the Board acknowledged the importance the health and social care teams working together to prevent silo working and ensure that physical and mental health were considered in an integrated way.

The Board resolved:-

(i)            to agree the consultation response in Appendix A, and instruct the Chief Officer to submit the response to the Scottish Government by the deadline of 31 January 2018;

(ii)          to instruct the Chief Officer to prepare an additional paper to be presented to the IJB in early 2018 to consider the Food Charter for the SFCPA; and

(iii)         to commit the Partnership to demonstrate leadership in this area and advocate for a range of measures to prevent, reduce and support the numbers of people who are overweight and obese in our population.

The Board had before it a report by Alex Stephen (Chief Finance Officer, ACHSCP) which presented the revised Board Assurance and Escalation Framework (BAEF) for approval.

The report recommended:-

That the Board approve the revised BAEF, as presented in Appendix A.

Alex Stephen advised that comments received from the Audit and Performance Systems Committee had been reflected in the Framework and these included the addition of the risk appetite statement and a simplified clinical and care governance structure.

Thereafter there were questions and comments on (1) the localities structure and the role of locality groups during consultation and decision making processes; and (2) members welcomed the Framework’s use of plain English and its overall accessibility.

The Board resolved

To approve the revised BAEF, as presented in Appendix A.

The Board had before it a report by Kenneth O’Brien (Service Manager, ACHSCP) which presented to the IJB for purposes of provision of information, supporting scrutiny of the Partnership’s delayed discharge performance.

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 discharge action plan; and

(c)          Instruct the Chief Officer to provide a further update on delayed discharge performance and actions taken to further improve performance in six months.

Kenneth O’Brien provided a six monthly update on delayed discharges and advised that performance in Aberdeen City had continued to steadily improve in both volume of delays and bed days lost and that per 100,000 population, Aberdeen’s performance was stronger than the national average. He cautioned that an uptick in the volume of delayed discharges was likely across December and January and surmised that this may be due to more patients and carers suffering from illness over this period. Mr O’Brien also provided an overview of the Delayed Discharge Action Plan and explained that good progress had been made since the launch of the National Power of Attorney awareness campaign; and he noted that the co-location of Flow Co-ordination, Care Management and Liaison Nursing teams at Woodend Hospital had been delivered to support joint working.

Thereafter there were questions and comments on (1) the use of terminology in relation to measures of productivity and efficiency savings; (2) the timescales for consultation and finalisation of the Choice Delayed Discharges policy; (3) the Partnership’s winter briefing which was due to take place in April; and (4) the rationale for the red rating in the Action Plan for Complex Patient-Bed Capacity.

The Board resolved:-

(i)            to note the Partnership’s current performance in relation to delayed discharges;

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

(iii)         to instruct the Chief Officer to provide a further update on delayed discharge performance and actions taken to further improve performance in six months;

(iv)         to request, where appropriate that terminology within future reports refer to efficiency savings as diverted activity efficiencies; and

(v)           to thank colleagues involved in supporting discharge for their good work in maintaining a positive trend of delayed discharge performance, particularly over the challenging winter period.

The Board had before it a report by Alison MacLeod (Lead Strategy and Performance Manager, ACHSCP) which sought IJB approval of the objectives stated in the baseline report and agree that the report could be submitted to MSG (Ministerial Strategic Group) immediately to meet their requested deadline of 31 January 2018.

The report recommended:-

That the Board –

(a)          Approve the revised MSG Integration Indicator objectives contained within the attached MSG indicator Baseline Report; and

(b)          Instruct the Chief Officer to submit the MSG Integration Indicator Baseline Report to MSG immediately to meet the deadline of 31 January 2018.

Alison MacLeod advised that the submission had been formatted as per MSG guidance and included a narrative and information on baselines, objectives and progress updates. Ms MacLeod explained that the objectives were realistic and took into account trends such as the steadying of delayed discharge improvement during 2017.

Thereafter there were questions and comments on (1) the risk that the Partnership may become too target driven at the expense of a person centred approach; and (2) members acknowledged that the submission was both comprehensive and easy to read.

The Board resolved:-

(i)           to approve the revised MSG Integration Indicator objectives contained within the attached MSG indicator Baseline Report; and

(ii)          to instruct the Chief Officer to submit the MSG Integration Indicator Baseline Report to MSG immediately to meet the deadline of 31 January 2018.

The Board had before it a report by Gail Woodcock (Lead Transformation Manager, ACHSCP) which provided an update to the IJB on the Transformation Plan and details of the transformation journey to date and highlights of the IJB’s priority deliverables.

The report recommended:-

That the Board –

(a)          Note the Transformation Plan; and

(b)          Endorse the progress made to date.

Gail Woodcock advised that the report provided an overview of the Transformation Plan since inception and outlined the key drivers and achievements to date.

Thereafter there were questions and comments on (1) the level of efficiency savings and its impact on resource and staff; (2) the role of the third sector in supporting the prevention agenda through partnership working and building community capacity; and (3) members welcomed the inclusion of the Emerging Outcomes Framework within the Plan.

The Board resolved:-

(i)            to note the Transformation Plan; and

(ii)          to endorse the progress made to date.

Councillor Samarai declared an interest in the following item as she was a volunteer befriender of the Living Well Project at Newhills Parish Church and would remain in the meeting during consideration of this item.

The Board had before it a report by Gail Woodcock which sought approval from the IJB to incur expenditure and for the Board to issue Directions to NHSG and Aberdeen City Council in relation to projects that sit within the Partnership’s Transformation Programme.

The report recommended:-

That the Board –

(a)          Agree to incur the expenditure relating to extending the contractual/grant arrangements in relation to (1) Thinc Social Transport; (2) Living Well Cafes; (3) Befriending Service (Sheddocksley Baptist Church); and (4) Dementia Post Diagnostic Support,

(b)          Instruct the Chief Officer to issue the Directions for the above projects to Aberdeen City Council, appending the relevant business case to each Direction.

Gail Woodcock advised that the report requested Board approval for expenditure on four projects that would support the Transformation Programme. She highlighted that in relation to the Dementia Post Diagnostic Support project, references to £78,000 should be disregarded and replaced by a figure of £84,388.50.

The Board resolved:-

(i)            to agree to incur the expenditure relating to extending the contractual/grant arrangements in relation to (1) Thinc Social Transport; (2) Living Well Cafes; (3) Befriending Service (Sheddocksley Baptist Church); and (4) Dementia Post Diagnostic Support; and to further approve the revised cost of £84,388.50 for this project; and

(ii)          to make the Directions for the above projects and instruct the Chief Officer to issue the Directions to Aberdeen City Council, appending the relevant business case to each Direction, and to further instruct the Chief Officer to amend the business case and Direction for the Dementia Post Diagnostic Support project to ensure the inclusion of the revised cost of £84,388.50 to extend this contract for a nine month period commencing 1 April 2018.

Luan Grugeon declared an interest in the following item as outlined in item 2 of this minute and chose to withdraw from the meeting during consideration of this item.

The Board had before it a report by Kevin Toshney (Planning and Development Manager, ACHSCP) which outlined additional information in respect of the Board’s commissioning intentions and market facilitation activity. The report also presented the revised Strategic Commissioning Implementation Plan and outlined the contributions and comments received during the consultation process.

The report recommended:-

That the Board –

(a)          Approve the revised Strategic Commissioning Implementation Plan;

(b)          Instruct the Chief Officer to put in place the required structures and resources to implement this plan; and

(c)          Request an annual update on the implementation of the Strategic Commissioning Implementation Plan to both the IJB and APS Committee.

Kevin Toshney advised that the Strategic Commissioning Plan wholly aligned with the vision and priorities set out in the Strategic Plan and its lifespan would cover the three year period of the revised Strategic Plan by remaining in effect until 2022. Mr Toshney explained that the Strategic Commissioning Plan had two parts: the first part outlined the Partnership’s commissioning principles and intentions, and its six areas of focus. He noted that the Strategic Commissioning Programme Board would oversee the implementation of the Plan. The Second part would address market facilitation and the challenges of commissioning external provision which was the first risk on the Strategic Risk Register. Mr Toshney then provided an overview of the consultation and engagement process that had been undertaken to ensure key stakeholders were afforded an opportunity to shape the Plan.

Thereafter Board members asked if Unison’s consultation response had been incorporated into the Plan and the Board agreed that reference should be made within the Plan to the Board’s endorsement of the Ethnical Care Charter.

The Board resolved:-

(i)            to approve the revised Strategic Commissioning Implementation Plan;

(ii)          to instruct the Chief Officer to put in place the required structures and resources to implement this plan; and

(iii)         to request an annual update on the implementation of the Strategic Commissioning Implementation Plan to both the IJB and APS Committee; and

(iv)         to request that reference is made within the Plan to the Board’s endorsement of the Ethical Care Charter.

The Board had before it a report by Sally Shaw (Head of Strategy and Transformation, ACHSCP) which provided an update on the developed vision of how health and social care partners sought to reimagine primary and community care in Aberdeen City.

The report recommended:-

That the Board –

(a)          Note the Reimagining Primary and Community Care report;

(b)          Instruct the Chief Officer to develop a detailed Communication Plan; and

(c)          Instruct the Chief Officer to develop an Engagement Strategy to develop the vision further with all stakeholders and to bring this back to the IJB in May 2018.

Sally Shaw provided an overview of the five main areas of challenge which were (1) Workforce; (2) Changing relationships with people and communities; (3) New practice principles (4) Estates and premises; and (5) IT and technology. She also stressed the importance of developing a Communication Plan and Engagement Strategy to support implementation.

Thereafter there were questions and comments on (1) the new General Medical Services Contract and the strategic role of IJBs, to which the Chief Officer confirmed that a proposed memorandum of understanding would be presented to the IJB on 27 March 2018; (2) the key role of social workers and care managers in this process and the importance that their functions and contributions are embedded into the report; (3) the role of the third sector in addressing the skills shortage and driving innovation and how the Partnership would engage with these colleagues; and (4) the importance of developing a robust and inclusive Communication Plan which would allow the workforce, key stakeholders and the general public to accept systemic change.

The Board resolved:-

(i)            to note the Reimagining Primary and Community Care report;

(ii)          to instruct the Chief Officer to develop a detailed Communication Plan;

(iii)         to instruct the Chief Officer to develop an Engagement Strategy to develop the vision further with all stakeholders and to bring this back to the IJB in May 2018; and

(iv)         to request that explicit references are made within the report to the key role of Social Work and Social Care colleagues.

The Board had before it a report by Kay Dunn (Lead Planning Manager, ACHSCP) which provided an update on the development of the business case for the Investment in Facilities to Modernise Primary and Community Care Services (PCCS) in Aberdeen City.

The report recommended:-

That the Board –

(a)          Note the initial agreement as outlined in Appendix A and that it aligns with the IJB’s strategic vision for primary care, prior to submission to the Scottish Government Health and Social Care directorate Capital Investment Group in January 2018;

(b)          Note that the initial agreement was presented to the NHSG Board on 7 December and a consultation process would now commence; and

(c)          Note that the Chief Officer chairs the programme board and that under Government requirements the NHSG Board is the decision maker for capital projects.

Kay Dunn advised that the Initial Agreement was approved by the Scottish Government Health and Social Care Directorate Capital Investment Group in 2014 to relocate the existing Denburn Medical Practice to a new purpose built community health and social care hub in close proximity to the Northfield and Mastrick communities. Ms Dunn provided an overview of the consultation process to ensure that key stakeholders and the general public were engaged and their views were encapsulated within the outline and full business cases. She explained that as issues of capital remained within the remit of NHS Grampian, its Board would be responsible for decision making.

Thereafter there were questions and comments on (1) the options available to patients currently registered at the Denburn Medical Practice when the Practice relocates; and (2) the opportunity that the report provided to put into effect the principles agreed in the previous agenda item (Primary Care) and agreed to endorse the report to the NHSG Board.

The Board resolved:-

(i)            to note the initial agreement as outlined in Appendix A and that it aligns with the IJB’s strategic vision for primary care, prior to submission to the Scottish Government Health and Social Care directorate Capital Investment Group in January 2018;

(ii)          to note that the initial agreement would be presented to the NHSG Board on 1 February 2018 and a consultation process would commence thereafter;

(iii)         to note that the Chief Officer chairs the programme board and that under Government requirements the NHSG Board is the decision maker for capital projects; and

(iv)         to endorse this report to the NHSG Board.

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 defer decision making on this item and to request that a report be re-presented to the Board on 28 August 2018 which would outline options for supporting board development; and

(ii)           to circulate board development materials prepared by the Good Governance Institute to IJB members who had recently become Board members.

The Board had before it a report by Jenny Rae (Planning Officer, Strategy and Transformation Team, ACHSCP) which sought approval for commissioning activity within the Learning Disability Service.

The Board resolved:-

To approve the recommendations within the exempt report.

Councillor Donnelly declared an interest in the following item by virtue of his directorship of Seabank House and would 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 mental health services and services for people with long term alcohol misuse, and sought approval of the plans to extend residential contracts and retender support services, approval of the total estimated expenditure and approval to award contracts following the completion of the tender process.  The report also sought approval for issuing a formal direction to Aberdeen City Council in this regard.

The Board resolved:-

To approve the recommendations within the exempt report, together with one additional resolution.

The Board had before it the exempt appendices to item 12 on today’s agenda (Transformation Decisions Required).

The Board resolved:-

To note the exempt appendices.

The Board then broke out for a workshop session and received presentations from Malcolm Wright (Chief Executive, NHSG) on the Regional Delivery Plan and Alex Stephen on the IJB Financial Strategy.

The Board resolved:-

To thank Mr Wright and Mr Stephen for their informative presentations.

COUNCILLOR SARAH DUNCAN, in the Chair.