Agenda, decisions and minutes

The Chair opened and welcomed everybody to the meeting. Councillors Bell and Dunbar, as new members, were introduced and welcomed to the Board.

Councillor Dunbar declared that she was a member of a group which received funding via IJB but that she did not intend to withdraw from the discussions.

The Board resolved:-

To note Councillor Dunbar’s comment and intention.

The Board resolved:-

to hear the Chief Officer’s update in public unless any matter required to be heard in private.

The Board resolved to:-

approve the minute of the Board Meeting of 22 January 2019.

The Board resolved to:-

review the Draft Minute of the Budget Meeting of 12 March 2019 at the next meeting of 11 June 2019.

The Board resolved to:-

approve the minute of the CCG Meeting of 19 February 2019.

The Board resolved to:-

approve the minute of the APS Meeting of 12 February 2019.

The Board had before it the Buisness Statement and heard that the document would be refreshed to include reporting on indentified worksstreams.

The Board resolved to:-

note the current Business Statement

The Board had before it the paper regarding appointments to the Board and to its committees. Following discussion, and whilst not all NHS Grampian members had been identified, the Board agreed that it was pragmatic to appoint members albeit perhaps only on an interim basis if required..

The Board resolved to:-:

(i)            Note that NHSG has appointed Kim Cruttenden, as a voting member to the IJB, and is to shortly appoint a further two voting members;

(ii)          Note that Aberdeen City Council has appointed Councillor Lesley Dunbar and Councillor Philip Bell as voting members to the IJB;

(iii)         Appoint Luan Grugeon, an NHSG voting member, as Vice Chair to the IJB;

(iv)         Review the membership for the Audit & Performance (APS) Committee and appointed Councillors Al-Samarai and Bell, and Luan Grugeon to this committee whilst awaiting appointment of a further NHSG voting member (four voting members to the committee, two from each representative organisation)

(v)          Review the membership for the Clinical & Care Governance (CCG) Committee and appointed Councillors Dunbar and Duncan, and Kim Cruttenden to this committee whilst awaiting appointment of a further NHSG voting member (four voting members to the committee, two from each representative organisation)

(vi)         Appoint Luan Grugeon as Interim Chairperson of the APS Committee whilst noting that this appointment would be reviewed upon appointment of the further NHSG voting members, and appoint Councillor Dunbar as Chairperson of APS Committee, ensuring that this followed the principles of equal representation.

(vii)        Reaffirm the IJB meeting schedule for 2019-20 attached as Appendix A.

The Board had before it the Strategic Risk Register and heard that this now included those risks previously discussed by the Board and identified the appropriate risk owner(s). During discussion it was heard that the document had improved greatly and assisted map the journey of the board. This showed the transition from transformation to business as usual.

The document allowed the Board to better focus on the risk areas particularly as they now aligned toe the new strategy.

The Board resolved to:-

Approve the revised Risk Register, as shown in Appendix A.

The Board had before it the paper which discussed the improvement in re-admissions. The Board heard from Alison MacLeod that the paper was requested following discussions arising from the Annual Report in August 2018. There had followed an investigation into the figures which were forwarded to the Unscheduled Care Group and the Clinical care Group for baselining.

The Board discussed that a report around the KPI’s could be brought to a future meeting to include some context around the figures. It was heard that the report indicated frailty as an issue to re-admission which would suggest further investigation within locality settings to see where any issues lay.

The Board resolved to:-

(i)            Note the finding of the analysis exercise.

(i)            Instruct the Chief Officer to investigate how the AHSCP performance compares to the Grampian wide performance by referring to the Unscheduled Care Group, and

(ii)          Refer the report to the Clinical and Care Governance Group proposing that they could potentially use some of the data – particularly that in relation to Respiratory Medicine, Cardiology and Infectious Diseases – as baseline indicators to measure the success of the Acute Care @ Home project

The Board had before it the report presented by Katie Cunningham and Anna Gale on the Health Improvement Fund. The Board heard the history of the fund which was annually recurring admnstered through the ACHSCP.

Since its inception, the HIF has been subject to ongoing review and refinement which concluded the fund and the processes adopted are meeting the funding principles and contributing to an increased preventative spend.

The Board commented that the report identified use of available funding which was possible to align with the IJB strategy and the LOIP. Opportunities were identified to encourage wider sharing of the learning with council colleagues.

The Board resolved to:-

(i) Note the content of the report contained in appendix A, including the contribution of the Fund towards achieving the principles of the Christie

Commission1 and Community Empowerment Act

(ii) Instruct the Chief Officer to bring an annual report relating to the Health Improvement Fund to the IJB in April 2020 and annually thereafter, and

(iii) Instruct the Chief Officer to further develop the HIF core and Neighbourhood Health: HIF to be directed through localities with the ambition to allocate funds through Participatory Budgeting in the future.

The Board had before it a report presented by Gail Woodcock. The paper resulted from an earlier report to the Board in October 2018 and followed consultation sessions and public events. The Board heard that this had resulted in  fairly positive feedback.

The report sought to provide assurances that existing good practice and service experience would not be lost, but that these were foundations upon which future delivery could be made. The Board heard that the restructure would align with partners which would better design benefits to all. It was accepted that not all localities have the same demands or requirements and that focus was required to improve outcomes for the whole population of Aberdeen.

Whilst discussions included concern of some challenges with the revised model and the pace of change, as the model matured it would be possible to identify learning and present this in a future report.

It was accepted that the differing descriptions and titles, both legally and locally, in use did not particularly assist easier understanding of locality work. This presented an opportunity to engage further with all interested parties to establish a common terminology.

The Board resolved to:-

(i) Agree to recognise three localities in the city, as per Appendix A.

(ii) Note the planned approach to strengthen and maximise benefits available through locality working through a co-production approach working with localities.

(iii) Instruct the Chief Officer to report back to the November 2019 meeting of the IJB with a further update on the implementation of the revised localities.

(iv) Instruct the Chief Officer to discuss opportunities for developing clear, distinct terminology for ACHSCP localities and Community Planning Partnership localities and report back with a recommendation to the IJB.

The Board had before it the report presented by Alison MacLeod who provided an overview of the report which had been amended following consultation, comment and feedback. Accepting that gaps had been identified, this plan would cover the period April 2019 to March 2022, although considerations had been given to a 5 year plan which it was felt was too long given the journey encountered in the previous 3 years.

The report would allow for greater accountability with the strategic performance dashboard providing better understanding and accessibility to make sometimes tough decisions.

The Board resolved to:-

(i)            Note the process undertaken to develop the Strategic Plan 2019-22 from the consultation draft they approved in December 2018.

(ii)          Approve the final draft of the Strategic Plan 2019-22.

(iii)         Instruct the Chief Officer to publish the Strategic Plan 2019-22 on the ACHSCP website.

The Board had before it the report prepared by Anne McKenzie ((Lead for Commissioning)) and presented by Alison MacLeod who provided information on the work undertaken thus far.

The Board heard that this report considered the principle area of identified risk and provided a positive way forward working collaboratively in a difficult area. This had been raised at national level and a further opportunity was offered to share with Chief Executives of ScotExcel.

The Board resolved to:-

(i)            Note the content of the report

The Board had before it the report presented by Alison MacLeod and heard heard that this was an extyension of free personal care and heard of the history around ‘Frank’s Law’.

The attached Action Plan detailed the delivery required and additional cost was also explained. A degree of unknown demand was discussed. The Board were keen to ensure those requiring such care could be assisted and it was suggested that auto enrolment was worthy of exploration as was service users awareness of potential benefits impact. Assurance was provided that Care managers and Key Workers were already engaged in such matters albeit it was the individual’s personal responsibility.

The Board highlighted that the numbers involved were a potential issue and that unmet demand would need to be monitored.

The Board resolved to:-

(i)            Note the introduction of Free Personal Care for under 65s on 1^stApril 2019 and the preparations ACHSCP have made for this.

(ii)          Endorse the Action Plan developed.

The Board had before it the report presented by Jenny Gordon (Public Health Dietician). The Board heard that whilst there was a national approach, Aberdeen had approached matters slightly differently. The GCGF required partner participation and multi level engagement.

The Board highlighted that this needed to tie in with Health and Wellbeing and promotion around Healthy Eating is required to assist the GCGF move forward.

The Board resolved to:-

(i)            Note the update report on ‘Granite City Good Food (GCGF)

(ii)          Support the principles of GCGF and its Charter though the ACHSCP action plan (in development)

(iii)         Instruct the Chair of the Integration Joint Board to sign of the (GCGF) charter on behalf of the ACHSCP

(iv)         Instruct the Chief Officer that an annual update on ACHSCP GCGF is presented to the IJB, and

(v)          Instruct the Chief Officer that the Grampian consultation strategies for Tobacco and Diet, Activity and Healthy Weight are presented to the Board

The Board had before it the report presented by Susie Downie ((Transformation Programme Manager). The Board heard the plan presented the strategic intent of a single cohesive group with a 3 year timescale.

The Board heard that the plan involved cultural change and that success was depenednet upon positive partner participiation. A colloborative approach would esnure joint principles and monitoring was essential for this difficult, but correct intention.

The Board resolved to:-

(i)            Approve the ACHSCP Empowered Workforce Plan (2019-21)

(ii)          To publish the ACHSCP Empowered Workforce Plan (2019-21)

The Board had before it the report prepared and presented by Gail Woodcock.

The Board heard that the report was presented in the usual manner and the decisions required were highlighted. Broadly, the transformation involved six large pieces of work identified into Programmes. Some of the projects were suitable for scaling up which would create further programmes.

The Board heard explanation on each of the subjects presented in the report and held discussion around each.

The Board resolved to:-

(i)            Approve the contract extension of the Link Working contract and delay a decision on the Custody Suite as set out in Appendix l, relating to the Link Working in Custody Suite and instruct the Chief Officer to submit a further updated report

(ii)          Approve the expenditure, as set out in Appendix l, relating to the Community Listening Service

(iii)         Delay a decision on the expenditure, as set out in Appendix A, for a replacement case management system for Adult Social Work whilst noting the business case in Appendix A and seek a further proposal to the June IJB that considers opportunities for a cross sectoral digital solution

(iv)         Note the progress towards developing integrated Unscheduled Care working in the City.

(v)          Approve the proposed project change relating to Community Link Working – Links Approach as set out in Appendix C, which would result in the continuation of the existing contract until 2022 and instruct the Chief Officer to submit updated reports to the respective  IJB and APS Committee.

(vi)         Make the Directions relating to the above projects as specified in Appendices D and F and instruct the Chief Officer to issue the Directions to NHS Grampian and Aberdeen City Council as appropriate.

The Board had before it the report presented by Teresa Waugh (Project Manager, Capital & Services) and Kay Dunn (Lead for Capital & Services) who provided an explanation around the report.

The Board heard that the intention was to make best use of available resources utilising existing, approved methods which included partner and community considerations. There had alos been consideration of 3^rd sector use and exploitation of time availability however limited budgets did impact possible enhanecements.

The dispersal of service users from elsewhere required relocation within the community which encouraged better use of existing facilities.

The Board resolved to:-

(i)            Approve the strategic direction for the delivery of Primary and Community Care Services (PCCS) set out within the summary of the Outline Business Case for the Denburn/Aurora Project (Appendix A).

(ii)          Agree that the Outline Business Case be submitted to the NHS Grampian (NHSG) Board on 4th of April 2019, with a recommendation to approve and submit to the Scottish Government

The Board had before it the report presented by Jason Nicol (Lead for Specialist Older Adults and Rehabilitation Services). The Board heard that the IJB required to issue a direction to ACC for the delivery of the Horizon service with associated budget. Staff would transfer under Transfer of Undertakings (Protection of Employment) Regulations 2006 (TUPE) from Bon Accord Care to ensure formal governance.

The Board resolved to:-

Make the Direction relating to the Horizons Rehabilitation Service from 1 April 2019, as specified in Appendix A and instruct the Chief Officer to issue the Direction to Aberdeen City Council.

The Board heard from the Chief Officer, Sandra Ross who provided the updates on the following.

Banks O’ Dee

Scottish Government Ministerial Self Evaluation

Leadership Team

The Board heard the updates included action actions arising from the journey taken thus far and that this learning and understanding would be shared with Board members who may not have been sighted on all aspects.

The Board noted the update provided.