Agenda, decisions and minutes

The Chair opened the meeting and welcomed Professor Steve Heys and Kenneth Simpson onto the Board and thanked departing members, Dr Stephen Lynch and Olivia Cockburn for their contributions to the integration of health and social care in Aberdeen City. He also advised that Sandra Ross would take up post as the new Chief Officer of the Aberdeen City Health and Social Care Partnership next week and thanked Sally Shaw for her leadership during her spells as both interim Chief Officer and Head of Strategy and Transformation.

The Chair informed the Board that Audit Scotland’s next report on health and social care integration was expected in November and encouraged all members to attend the IJB Developmental Workshop session on 18 September which would focus on the development of the new three-year Strategic Plan. He also highlighted the Partnership’s continued improvement in reducing the volume of delayed discharges and advised that for the first time ever, ACHSCP was amongst the top 25% performing partnerships in terms of delayed discharge performance.

The Chair also announced that Cllr Imrie had recently given birth to a baby girl and on behalf of the Board he sent congratulations and best wishes to her and her family. 

The Board resolved:-

(i)           to welcome Prof Steve Heys and Kenneth Simpson onto the Board;

(ii)          to thank Dr Stephen Lynch and Olivia Cockburn for their contributions to the integration of health and social care in Aberdeen City;

(iii)         to welcome Sandra Ross as the Partnership’s new Chief Officer;

(iv)         to thank Sally Shaw for her leadership as interim Chief Officer and Head of Strategy and Transformation;

(v)          to commend Kenny O’Brien and his team on the continued improvement in delayed discharge performance; and

(vi)         to congratulate Cllr Imrie on the birth of her daughter and to send the Board’s best wishes to her and her family.

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 agenda items 14-18 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 6 and 8 of Schedule 7(A) of the Act.

The Board had before it the minute of the IJB meeting of 22 May 2018.

The Board resolved:-

To approve the minute as a correct record.

The Chair asked if there were any matters arising from the meeting of 22 May 2018.

The Board resolved:-

There were no matters arising.

The Board had before it the minute of the Chief Officer Short Leet Meeting of 22 May 2018.

The Board resolved:-

To note the minute.

The Board had before it the minute of the Chief Officer Appointment Panel of 1 June 2018.

The Board resolved:-

To approve the minute as a correct record.

The Board had before it the draft minute of the Clinical and Care Governance Committee of 12 June 2018 for information.

The Board resolved:-

(i)         to request the Chief Finance Officer to provide an update to IJB members on fire safety compliance; and

(ii)        otherwise note the draft minute.

The Board had before it the draft minute of the Audit and Performance Systems Committee of 12 June 2018 for information.

The Board resolved:-

To note the draft minute.

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

The Chair advised that a number of items on the Business Statement had been delayed in recognition of a new Chief Officer taking up post. He added that an update on reporting timescales would be provided to the Board at its next meeting.

The Board resolved:-

(i)         to agree to remove item 1 (Standing Orders) and item 15 (Financial Monitoring) from the Statement; and

(ii)        otherwise note the Business Statement.

The Board had before it a report by Gail Woodcock (Lead Transformation Manager, ACHSCP) which presented the Primary Care Improvement Plan (PCIP) for approval.

The report recommended:-

That the Board approve the Primary Care Improvement Plan.

Gail Woodcock advised that following the new General Medical Services (GMS) Contract coming into effect in April 2018, each IJB was required to produce a PCIP to outline aims and priorities for releasing GP capacity. She highlighted that a city-wide GMS Implementation Leadership Group had been established to lead on the consultation and engagement process and had identified the following priorities (1) The Vaccination Transformation Programme; (2) Pharmacotherapy Services; (3) Community Treatment and Care Services; (4) Urgent Care (advanced practitioners); (5) Additional Professional Roles; and (6) Community Links Practitioners. Ms Woodcock explained that the PCIP was a high level, working document which would be revised on an ongoing basis. She also confirmed that business cases were being developed and the implementation plan would be monitored by the Audit and Performance Systems Committee.

Thereafter there were questions and comments on (1) the level of public consultation undertaken by the Partnership, with particular focus on engagement with the Aberdeen Civic Forum and community councils; (2) the possible impact of the new GMS Contract on the provision of primary care services, with particular focus on community pharmacists and the introduction of multi-disciplinary teams; (3) the delivery of the PCIP implementation plan which would include performance measures to monitor the achievement of outcomes; and (4) the Chief Finance Officer confirmed that the Partnership had budgeted for the receipt of recurring funding from the Scottish Government.

The Board resolved:-

(i)         to approve the Primary Care Improvement Plan; and

(ii)        to note that an implementation plan would be developed which would be configured around the practice of improvement and that performance would be monitored by the Audit and Performance Systems Committee.

The Board had before it a report by Gail Woodcock which presented the Action 15 Plan for approval.

The report recommended:-

That the Board approve the Action 15 Plan.

Gail Woodcock advised that the National Mental Health Strategy outlined a number of actions for public authorities to undertake, including Action 15 which covered access to mental health services in four key settings (1) Accident and Emergency Departments; (2) GP Practices; (3) Police Stations; and (4) Prisons. She then summarised the Partnership’s communication and engagement activities and confirmed that an implementation plan was being developed and its delivery would be monitored by the Audit and Performance Systems Committee.

Thereafter the Board recommended that the Partnership engage with the Community Planning Aberdeen Community Justice Group and participate in its upcoming workshop session.

The Board resolved

(i)         to request that officers from the Partnership participate in the forthcoming Community Planning Aberdeen Community Justice Group workshop session to ensure that the Action 15 Plan forms part of broader discussions on improving mental health care; and

(ii)        otherwise approve the Action 15 Plan.

The Board had before it a report by Gail Woodcock which presented the Technology Enabled Care Framework for information.

The report recommended:-

That the Board note the Technology Enabled Care Framework.

Gail Woodcock advised that the Technology Enabled Care Framework was linked to the Primary Care Improvement Plan and Action 15 Plan through its use of technology and digital solutions to reduce health inequalities. She explained that the Framework had been developed to assist in the planning, prioritisation and implementation of technology enabled care and that a tiered framework had been developed to reflect that different types of need required different types of intervention. Ms Woodcock also advised that a marketing approach would be adopted to increase public awareness of the availability and benefits of using technology to manage health and wellbeing.

Thereafter there were questions and comments on (1) possible equality implications for service users who didn’t have the capacity or dexterity to operate emerging technology; (2) the impact of the General Data Protection Regulation and the constraints it placed on the Partnership in terms of data sharing; (3) the importance of prioritising emerging technologies at a national level to mitigate against workforce recruitment challenges; (4) the need for a Charging policy to set out which health and social care equipment would be free of charge and which would incur a cost; and (5) there was discussion on broadband and connectivity challenges within Aberdeen City, with particular focus on the City Council’s rollout of its City Fibre programme and its work with Scotland Excel.

The Board resolved:-

(i)         to note the Technology Enabled Care Framework;

(ii)        to request a workshop session on technology enabled care which would inform the development of an implementation plan; and

(iii)       to request officers to develop proposals on how the Partnership’s digital programme would align with Aberdeen City Council and NHS Grampian’s digital agendas and present this to a future meeting of the Board.

The Board had before it a report by Kevin Toshney (Planning and Development Manager, ACHSCP) which presented the Partnership’s annual report for approval.

The report recommended:-

That the Board –

(a)          Approve the ACHSCP Annual Report 2017-18;

(b)          Agree that this annual report should be published on the Partnership’s website; and

(c)          Instruct the Chief Officer to present the approved annual report to Aberdeen City Council and NHS Grampian.

Kevin Toshney explained that the Partnership was statutorily required to publish an annual report and advised that the Partnership had delivered a reasonable standard of performance with areas of strength including (1) reductions in the number of delayed discharges; (2) reductions in the number of emergency admissions to hospital; and (3) an increase the number of commissioned services rated as good or better. However, he outlined a number of areas where improvement was needed including (1) the number of hospital readmissions after 28 days; (2) the percentage of carers feeling supported; and (3) the overall life expectancy for people living in Aberdeen was lower than the Scottish average. Mr Toshney informed the Board that an action plan would be developed by the Performance Management Group to address areas which required improvement and confirmed that performance would be monitored by the Audit and Performance Systems Committee.

Thereafter there were questions and comments on (1) the consultation process undertaken for the annual report, with particular reference to the level of engagement with community councils; (2) the robustness of carers data within the report as it was relatively historic; (3) how the Partnership intended to evidence improvement and monitor the achievement of outcomes; and (4) whether the Partnership was in a position to report the findings of the Care Inspectorate’s inspection of adult social care services and its proposed response within the final version of the annual report. Mr Toshney advised that a brief update would be added to this year’s Annual Plan, with a more detailed response to be included in next year’s Annual Plan to capture the findings of the recently completed follow up inspection.

The Board resolved:-

(i)         to approve the ACHSCP Annual Report 2017-18;

(ii)        to agree that the Annual Report should be published on the Partnership’s website;

(iii)        to instruct the Chief Officer to present the approved annual report to Aberdeen City Council and NHS Grampian;

(iv)      to request that an update on the Care Inspectorate’s inspection of adult social care services be inserted into the Annual Report, with a note explaining that an action plan was being developed;

(v)       to note that performance monitoring was within the remit of the APS Committee, and following submissions to the Committee, a progress update on performance would be circulated to IJB members for assurance purposes;

(vi)      to request that the Annual Report be circulated to all Aberdeen City community councils for information; and

(vii)    to thank all Partnership staff for their work over the previous year.

The Board had before it a report by Gillian Parkin (Finance, NHSG) 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 3 (end of June 2018); (2) advised on any areas of risk and management action relating to the revenue budget performance of 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 herein; and

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

Alex Stephen advised that an adverse position of £323,000 had been reported as at the end of June 2018 which was in line with forecasts set out in the Medium-Term Financial Strategy. He also highlighted the steps the Partnership had been taking to manage budget pressure including a review of base budgets against last year’s outturn position and an audit of Care First to determine the accuracy of information on residential clients.

Thereafter there was a discussion on the Partnership’s engagement with other Grampian Health and Social Care Partnerships and Chief Executives of NHS Grampian and regional councils on controlling the costs of hosted services.

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 were contained therein; and

(ii)        to approve the budget virements indicated in Appendix E.

The Board had before it a report by Alison MacLeod (Lead Strategy and Performance Manager, ACHSCP) which presented the Local Guidelines on the Waiving of Charges for Services for approval.

The report recommended:-

That the Board approve the Local Guidelines on the Waiving of Charges for Services to Carers.

Alison MacLeod explained that in response to the Carers (waiving of charges for support) (Scotland) Amendment Regulations 2018, the Board requested information on how the regulations would be applied locally and advised that the guidelines were a first step in addressing this issue. She added that a national group had been established to analyse case studies and develop best practice on waiving charges for carers and the group would pay cognisance to the 2018 regulations; primary legislation and statutory guidance. Ms MacLeod also provided an overview of the consultation process followed by the Partnership when developing the local guidelines and she particularly highlighted the positive engagement with local and national carer groups.

Thereafter there were questions and comments on (1) the consultation process, with particular reference to engagement with carers; (2) whether an easy-read version of the guidelines should be produced to increase understanding and accessibility; (3) the shared responsibility between the Partnership and Voluntary Service Aberdeen (VSA) for signposting carers to help them access support services; and (4) members agreed that despite the lack of available data, the production of local guidelines was a credible first step.

The Board resolved:-

(i)         to note that formatting issues within the draft guidelines had been identified and would be resolved prior to formal publication;

(ii)        to approve the Local Guidelines on the Waiving of Charges for Services to Carers;

(iii)       to instruct the Lead Strategy and Performance Manager to prepare an easy-read version of the local guidelines; and

(iv)      to instruct the Lead Strategy and Performance Manager to prepare progress updates on implementation and for these to be reported to the Audit and Performance Systems Committee.

The Board had before it a report by Martin Allan (Business Manager, ACHSCP) which (1) outlined the work of the Career Ready and Developing the Young Workforce and the links these organisations have in the Partnership’s Workforce Plan; and (2) to get approval from the Board to fund internships relating to Career Ready and to further develop the work between the DYW, the Partnership (across a variety of service areas) and Hazlehead and Harlaw Academies, as well as exploring links and projects undertaken by other public sector bodies to further enhance the Partnership’s Workforce Plan.

The report recommended:-

That the Board –

(a)         Endorse the continuation of collaboration with both Career Ready and Developing the Young Workforce (DYW) as part of the Partnership’s overall Workforce Plan;

(b)         Agree to the funding of two mentoring arrangements through Career Ready in the Partnership for 2018/2020 at a cost of £800 per arrangement; and

(c)          Agree to further develop the work that DYW are doing with the Partnership and Harlaw Academy and Hazlehead Academy as detailed in the report.

Martin Allan advised that the purpose of the report was to endorse the Partnership’s collaboration with Career Ready and Developing the Young Workforce and request Board approval to fund two mentoring programmes within the Partnership for 2018-20.

Thereafter there were questions and comments on (1) how the Partnership was securing best value from its participation in these programmes; and (2) how the Partnership’s Workforce Plan tied in with the priorities of local education providers and aligned with the Primary Care Improvement Plan.

The Board resolved:-

(i)         to endorse the continuation of collaboration with both Career Ready and Developing the Young Workforce (DYW) as part of the Partnership’s overall Workforce Plan;

(ii)        to agree to the funding of two mentoring arrangements through Career Ready in the Partnership for 2018/2020 at a cost of £800 per arrangement; and

(iii)      to agree to further develop the work that DYW are doing with the Partnership and Harlaw Academy and Hazlehead Academy as detailed in the report.

The Board had before it a report by Lorraine McKenna (Head of Central Locality, ACHSCP) which informed the Board of the decision of the Rosemount Medical Group to stop delivering General Medical Services from 31 January 2019 and to provide the Board with options on its next steps.

The Board resolved:-

To approve the recommendations within the exempt report, along with two additional resolutions

The Board had before it a report by Alex Stephen (Chief Finance Officer, ACHSCP) which sought the Board’s agreement to proceed with a service level agreement with Bon Accord Care to secure ongoing provision of residential care services at Kingswells Care Home for older people with significant physical dependency and frailty who present with complex dementia.

The Board resolved:-

To approve the recommendations within the exempt report, along with two additional resolutions.

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

The Board resolved:-

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

The Board had before it a report by Alison MacLeod which advised the Board of the three main approaches to allocating the commissioning budget and sought approval of these approaches and various specific funding decisions.

The Board resolved:-

To approve the recommendation within the exempt report.

The Board had before it a report by Alex Stephen which requested permission from the Board to tender for support to help in the continued development of the Board.

The Board resolved:-

(i)         to agree in principle to commission external governance support, and if proposed expenditure is above £50k to submit a Direction to a future meeting of the IJB, otherwise note that authority to agree contracts below the value of £50k is delegated to the Chief Officer; and

(ii)        to agree to quarterly development sessions out-with committee meeting dates and instruct the Committee Clerk to identify suitable dates.

JONATHAN PASSMORE MBE, Chairperson.