Agenda, decisions and minutes

The Chair opened the meeting and advised that today’s meeting would be Dr Nick Fluck’s last before being replaced by Dr Steve Heys, and thanked him for his contributions to the Board and to integration of health and social care in Aberdeen City. The Chair explained that there was no workshop session after today’s meeting as a short-leet meeting had been arranged to consider prospective candidates for the Chief Officer post. He informed the Board that following the risk workshop on 24 April 2018, the Strategic Risk Register would not be reviewed at today’s meeting and suggested that the register be referred to the next Audit and Performance Systems Committee for further development.

The Chair also highlighted that Aberdeen City’s Learning Disability Strategy had recently been launched and expressed how humbled he had been to attend the event and see the values of the IJB on display at the launch.

The Board resolved:-

(i)           to thank Dr Nick Fluck for his services to the Board and his contribution towards the integration of health and social care in Aberdeen City;

(ii)          to refer the Strategic Risk Register to the next meeting of the Audit and Performance Systems Committee for further development; and

(iii)         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.

To agree to consider items 18 (Skills Framework), 19 (Funding to a Voluntary organisation), 20 (Kingswells Care Home), 21 (Bon Accord Care Contract Review) and 22 (GMS Services to Torry Neighbourhood) with the press and public excluded.

The Board had before it the minute of the IJB meeting of 27 March 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 27 March 2018.

The Board resolved:-

To note there were no matters arising.

The Board had before it the minute of the Special IJB meeting of 10 April 2018.

The Board resolved:-

To approve the minute as a correct record.

The Chair asked if there were any matters arising from the Special IJB meeting of 10 April 2018.

The Chair advised that the Assessment Centre for the Chief Officer post would be held on 31 May 2018 and encouraged all Board members to take part in the stakeholder panel.

The Board resolved:-

To note the information provided.

The Board had before it the draft minute of the Clinical and Care Governance Committee of 20 March 2018 for information.

The Board resolved:-

To note the draft minute.

The Board had before it the draft minute of the Audit and Performance Systems Committee of 10 April 2018 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 agree to remove item 1 (Delegated Functions and Services) and item 4 (IJB Meetings) from the Statement;

(ii)        to note that a report on item 11 (Mental Health Commissioning) outlining the  challenges relating to the re-provision of care, with particular focus on the housing element would be presented to the Board on 28 August 2018; and

(iii)      otherwise note the Business Statement.

The Board had before it a report by Iain Robertson (Governance, ACC) which reviewed the terms of reference for the Audit and Performance Systems (APS) and Clinical and Care Governance Committees and asked the Board to appoint a member onto the APS Committee.

The report recommended:-

That the Board –

(a)          Approve the revised Standing Orders and Committee Terms of Reference attached as Appendices A, B and C;

(b)          Agree to review Committee Terms of Reference along with the wider IJB Scheme of Governance on an annual basis; and

(c)          Appoint an Aberdeen City Council voting member onto the Audit and Performance Systems Committee.

Iain Robertson advised that a short term governance working group had reviewed the terms of reference and made a number of revisions to formatting and substantive changes which reflected how committees had been operating in practice. He recommended that the terms of reference be reviewed annually alongside the wider IJB scheme of governance to ensure that a system-wide and complementary approach could be adopted. Mr Robertson also recommended that the Board appoint a Council voting member onto the APS Committee to fill the current vacancy and uphold the representation principle set out in standing orders.

Thereafter there were questions and comments on (1) how to increase public participation in committee business; and (2) the process for determining when the Clinical and Care Governance Committee would become accessible to the public and press.

The Chair moved, seconded by the Vice Chair that the following appointments be made to the committees:-

Audit and Performance Systems Committee – Rhona Atkinson (Chair), Jonathan Passmore, Cllr Laing and Cllr Samarai.

Clinical and Care Governance Committee - Cllr Imrie (Chair), Cllr Duncan, Luan Grugeon and Dr Nick Fluck/Dr Steve Heys.

The Board resolved:-

(i)         to approve the revised Standing Orders and Committee Terms of Reference attached as Appendices A, B and C;

(ii)        to agree to review Committee Terms of Reference along with the wider IJB Scheme of Governance on an annual basis;

(iii)      to appoint Rhona Atkinson (Chair), Jonathan Passmore, Cllr Laing and Cllr Samarai  onto the Audit and Performance Systems Committee; and to appoint Cllr Imrie (Chair), Cllr Duncan, Luan Grugeon and Dr Nick Fluck/Dr Steve Heys onto the Clinical and Care Governance Committee.

The Board had before it a report by Alan Thomson (Governance, ACC) which advised of the need to appoint a Data Protection Officer for the IJB.

The report recommended:-

That the Board approve the appointment of a Data Protection Officer (DPO) for the Integration Joint Board and instruct the Chief Officer to make the necessary arrangements with the relevant Partner.

Martin Allan (Business Manager, ACHSCP) advised that NHS Grampian had offered to provide DPO services to the IJB and proposed that its Information Governance Lead be appointed as the IJB’s DPO.

Thereafter there were questions and comments on (1) the provisions within the Integration Scheme which set out that both Aberdeen City Council and NHS Grampian would provide services and administrative support to the IJB, which would include DPO services; and (2) the arrangements for the DPO to report to the Board and/or Audit and Performance Systems Committee.

The Board resolved

To approve the appointment of NHS Grampian’s Information Governance Lead (Roohi Bains) as the Data Protection Officer for the Integration Joint Board and instruct the interim Chief Officer to make the necessary arrangements with NHS Grampian.

The Board had before it a report by the Chief Finance Officer which allowed members to review and comment on the unaudited final accounts for 2017-18.

The report recommended:-

That the Board consider and comment on the Unaudited Accounts for 2017-18.

Alex Stephen noted that publication of the accounts had been brought forward to align with the scheduling of the Council’s group accounts. Mr Stephen explained that the audited annual accounts would be presented to the Audit and Performance Systems Committee for approval on 12 June 2018.

Thereafter there were questions and comments on (1) the importance of using plain English to make the accounts as accessible as possible to the public; (2) progress with regards to locality working and the wider transformation programme; and (3) the importance of outlining potential opportunities, as well as costs and risks when implementing the Carers Strategy.

The Board resolved:-

(i)         to review the rationale outlined on page 82 of Appendix A for the slower than anticipated progress on delivery of the transformation work; and

(ii)        otherwise note the Unaudited Accounts for 2017/18.

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 12 (end of March 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 D.

Alex Stephen advised that an adverse position of £3,480,000 had been recorded for mainstream budgets for 2017-18 and the usable reserves position at Year End was £8,306,965. He pointed out that reserves were no longer included within the financial monitoring report and would now be reported separately to give Board members a clearer picture on the mainstream financial position. Mr Stephen projected that prescribing and social care pressures would be the main drivers of anticipated adverse movements in the short-medium term. 

Thereafter there were questions and comments on (1) the anticipated timescale for service redesign plans to be brought to the Board for decision making; (2) the cost pressures impacting on the delivery of transformation projects; and (3) the importance of developing solutions at Board level to address current overspends within out of area placements, hosted services and prescribing budgets.

The Board resolved:-

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

(ii)        to approve the budget virements indicated in Appendix D; and

(iii)      to request that a report be presented to August’s Board meeting on the delivery of mainstream services, with a focus on cost pressures, key actions for future improvement and delivery timescales. The report should pay particular attention to (1) prescribing, (2) hosted services and (3) out of area placements.

The Board had before it a report by Jillian Evans (Head of Health Intelligence, NHSG) and Alison MacLeod (Lead Strategy and Performance Manager, ACHSCP) which provided an update on Partnership performance against the National Core Suite of Integration indicators and other high level performance measures.

The report recommended:-

That the Board –

(a)          Note the performance and progress of the partnership against the national and local performance indicators currently reported; and

(b)          Note the planned development work on performance reporting.

Alison MacLeod advised that the Audit and Performance Systems (APS) Committee had requested a review of performance indicators at its meeting on 2 March 2018 as members felt that data was historic and unrepresentative which made it difficult to quantify the level of impact the Partnership was having on the delivery of health and social care services. She explained that new indicators would be reported to the APS Committee in September and thereafter to the Board in December. Ms MacLeod added that data from the 2017-18 bi-annual survey was being collated by Health Intelligence and would be made available later in the year.

Thereafter there were questions and comments on (1) the level of data produced by HMP Grampian as the majority of offenders return to Aberdeen City at the end of their sentences; (2) if the Partnership liaised with Community Planning Aberdeen to share local data; and (3) how the Board could gauge if the Transformation Programme was making a difference, if current indicators were neither robust or representative.

The Board resolved:-

(i)         to note the performance and progress of the partnership against the national and local performance indicators currently reported;

(ii)        to note the planned development work on performance reporting;

(iii)      to request the interim Chief Officer to explore the possibility of sharing data that was locally produced by Community Planning Aberdeen’s (CPA) Local Outcome Improvement Groups and Locality Partnerships; and

(iv)      to request the interim Chief Officer to raise concern at the next meeting of the Chief Officers Group with regards to the representativeness and robustness of data derived from bi-annual surveys which were used to populate national integration indicators N1 to N9 and discuss whether an approach should be made to Scottish Government to propose alternative measures or methodologies.

The Board had before it a report by Kevin Toshney (Planning and Development Manager, ACHSCP) which presented a timeline for the review and refresh of the current Strategic Plan to the IJB for its consideration and approval.

The report recommended:-

That the Board –

(a)          Note the proposed developmental timeline for the Strategic Plan 2019-2022;

(b)          Agree that an initial draft of the Strategic Plan should be presented to the IJB at its scheduled meeting in October 2018; and

(c)          Agree that a ‘Consultation’ draft of the Strategic Plan should be presented to the IJB at its scheduled meeting in December 2018.

Kevin Toshney set out the proposed timeline for the development and consultation of the refreshed Strategic Plan. He advised the review would assess the achievements of the existing Plan with a view to evaluating future values, priorities and aspirations. He added that a Community Engagement Plan was being developed based on a Community Planning Aberdeen template to ensure a broad level of engagement with individuals, groups and carers that use, or chose not to use ACHSCP services.

Thereafter there were questions and comments on the consultation process, with particular discussion on engagement with Community Planning Aberdeen and Public Health.

The Board resolved:-

(i)         to note the proposed developmental timeline for the Strategic Plan 2019-2022;

(ii)        to request a workshop session on 28 August 2018 on strategic planning, and to invite the Community Planning Manager and other community planning partners to this session;

(iii)      to request strong alignment of engagement and participation activities between ACHSCP and CPA during the review of the IJB Strategic Plan;

(iv)      to agree that an initial draft of the Strategic Plan be presented to the IJB at its scheduled meeting in October 2018;

(v)        to instruct the interim Chief Officer to present an initial draft of the Strategic Plan to both the CPA Management Group and CPA Board for consultation; and

(vi)      to agree that a ‘Consultation’ draft of the Strategic Plan be presented to the IJB at its scheduled meeting in December 2018.

The Board had before it a report by Alison MacLeod which sought approval of the Carer’s Eligibility Criteria which was attached as Appendix A and sought approval of the process for managing and allocating the 2018/19 funding received for the implementation of the Carers (Scotland) Act 2016.

The report recommended:-

That the Board –

(a)          Approve the Eligibility Criteria for Carers; and

(b)          Approve the Managing Carer Implementation Funding process.

Alison MacLeod advised that the eligibility criteria and funding process had been based on statutory guidance and was a requirement of the Carers (Scotland) Act 2016. She also summarised the governance arrangements to oversee implementation of the eligibility and funding allocation process.

Thereafter there were questions and comments on (1) the eligibility thresholds for young and adult carers; (2) the use of eligibility funding to deliver preventative care within communities; and (3) the projected impact on the carers budget for its first three years.

The Board resolved:-

(i)         to approve the Eligibility Criteria for Carers; and

(ii)        to approve the Managing Carer Implementation Funding process.

The Board had before it a report by Gail Woodcock (Lead Transformation Manager, ACHSCP) which provided an update on the development of the Primary Care Improvement Plan for the Partnership.

The report recommended:-

That the Board –

(a)          Note the progress towards developing the City’s Primary Care Improvement Plan;

(b)          Instruct the Chief Officer to submit the complete Primary Care Improvement Plan to the Scottish Government within the required timescale, following consultation with the Chair and Vice Chair of the IJB; and

(c)          Instruct the Chief Officer to bring back an update report to the August 2018 meeting of the IJB, including the finalised Primary Care Improvement Plan.

Gail Woodcock advised that the GMS Contract had been agreed in March 2018 and Aberdeen City had set up an Implementation Leadership Group to oversee Contract delivery. She highlighted that consultation was ongoing with individual GP practices and a number of responses had already been received. Ms Woodcock explained that due to tight timescales for reporting the statutory Plan to Scottish Government, she proposed that the Plan be submitted to the Scottish Government in July, following consultation with the IJB Chair and Vice Chair. The IJB would then be given an opportunity to review the report at its next meeting on 28 August 2018.

Thereafter there were questions and comments on (1) when funding confirmation was expected from Scottish Government; (2) the short timescales for developing and approving the Plan in order to meet the statutory reporting deadline of July 2018; and (3) members discussed whether there was any scope for delaying the Plan’s submission to Scottish Government, or if not, whether a Special IJB meeting should be arranged to ensure Board approval of a statutory document.

The Board resolved:-

(i)         to note the progress towards developing the City’s Primary Care Improvement Plan;

(ii)        to request the Lead Transformation Manager to circulate an initial draft of the Primary Care Improvement Plan to members by email;

(iii)      to instruct the interim Chief Officer to contact the Scottish Government to explore if there was any flexibility on the Plan’s submission date;

(iv)      in the event that there was no scope for flexibility as outlined in (iii), to instruct the Clerk to arrange a Special IJB meeting on 12 June 2018 to formally approve the Plan before submission to the Scottish Government;

(v)        to request the Clinical Director to explore whether the GP Sub Group could move their approval meeting for the Plan prior to 12 June 2018; and

(vi)      to request the interim Chief Officer to raise concern at the next meeting of the Chief Officers Group with regards to the short timescales for consulting on, approving and submitting a statutory plan.

The Board had before it a report by Teresa Waugh (Project Manager, ACHSCP) which presented the updated Aberdeen City Primary Care Priorities 2018-19 for approval and to align this work with the annual review of the NHSG Primary Care Premises Plan 2018-2028.

The report recommended:-

That the Board –

(a)          Approve the updated list of Aberdeen City Primary Care Priorities 2018 – 2019;

(b)          Note that the priorities are in line with the Aberdeen City Health & Social Care Partnership Strategic Plan 2016 – 2019 and current service priorities identified; and

(c)          Instruct officers to submit the Aberdeen City Primary Care Premises Plan annual update 2018 – 2019 to NHS Grampian and the Scottish Government.

Kay Dunn (Capital and Planning Services, NHS Grampian) explained how primary care priorities were scored and the role of the Primary Care Premises Group which both assessed the priority areas and awarded in-year grants to upgrade primary care premises. Ms Dunn advised that the 2018-19 Primary Care priorities for Aberdeen City were as follows:- (1) Denburn/Northfield/Mastrick; (2) North Corridor; (3) Torry; (4) Danestone; and (5) Countesswells.

Thereafter there were questions and comments on (1) the rationale for placing the premises for the Danestone Medical Practice in the Danestone, Banchory and Ellon project; and (2) the potential impact of new housing developments in Countesswells and the North Corridor on the level of demand for health and social care services.

The Board resolved:-

(i)         to approve the updated list of Aberdeen City Primary Care Priorities 2018 – 2019;

(ii)        to note that the priorities are in line with the Aberdeen City Health & Social Care Partnership Strategic Plan 2016 – 2019 and current service priorities identified;

(iii)      to instruct officers to submit the Aberdeen City Primary Care Premises Plan annual update 2018 – 2019 to NHS Grampian and the Scottish Government; and

(iv)      to request a workshop session focussing on process and sequencing of consultation and approval by ACC, NHSG and the IJB for capital investments.

The Board had before it a report by Jean Stewart-Coxon (Commercial and Procurement Services) which (1) provided an update on the outcome of the tender that was undertaken for Skills Development, Training and Employability Services for Aberdeen City and Aberdeenshire Health and Social Care Partnerships; and (2) sought approval to implement the recommendations of the evaluation panel, as set out in the report attached at Appendix 1.

The Board resolved:-

(i)         to approve the implementation of the recommendation of the tender evaluation panel;

(ii)        to make the Direction attached at Appendix 3 and instruct the interim Chief Officer to issue the Direction to Aberdeen City Council; and

(iii)      to instruct the interim Chief Officer to report back with the outcome of the local negotiations and a proposed way forward beyond the interim period to take account of the Strategic Commissioning Plan and the need to commission on the basis of outcome delivery.

The Board had before it a report by Alison MacLeod on grant funding to a voluntary organisation.

The Board resolved:-

(i)            to make the Direction, as at Appendix A and instruct the interim Chief Officer to issue the direction to Aberdeen City Council; and

(ii)          to approve the allocation of resource to explore enhanced integrated working.

The Board had before it a report by Kay Dunn on future arrangements for residential care services at Kingswells Nursing Home.

The Board resolved:-

To approve the revised recommendations within the exempt report.

The Board had before it a report by the interim Chief Officer on the conclusions of the Bon Accord Care contract review and on-going recommendations.

The Board resolved:-

To approve the revised recommendations within the exempt report.

Councillor Samarai informed the Board that she disagreed with its decision on this item and requested that her dissent be recorded in the minute.

The Board had before it a report by Emma King (Head of Locality, ACHSCP) and Susie Downie (Transformation Programme Manager, ACHSCP) which presented a proposal for future delivery of General Medical Services (GMS) to the population of Torry from 1 August 2018.

The Board resolved:-

To approve the recommendations within the exempt report.

JONATHAN PASSMORE MBE, Chairperson