Agenda and minutes

Apologies for absence were received from Susan Ringwood.

Sarah Compton Bishop declared a non-financial interest in savings reference 2122-48 contained within Appendix 1 of item 11(g) of the agenda (Budget Proposals 2021-22) in relation to the Jura Care Centre Respite Flat by virtue of having a family member resident within the centre.

Integration Joint Board held on 27 January 2021

The Minutes of the meeting of the Integration Joint Board held on 27 January 2021 were approved as a correct record.

Betty Rhodick joined the meeting during consideration of the following item of business.

 

 

The Minutes of the meeting of the Clinical and Care Governance Committee held on 14 January 2021 were noted.

The Minutes of the meeting of the Audit and Risk Committee held on 23 February 2021 were noted.

 

The Chair of the Audit and Risk Committee, Councillor Sandy Taylor, provided an update on the commitment to produce an IT Strategy and confirmed the appointment of Argyll and Bute Council as auditors of the Integration Joint Board.

 

The Minutes of the meeting of the Finance and Policy Committee held on 26 February 2021 were noted.

The Minutes of the meeting of the Clinical and Care Governance Committee held on 18 March 2021 were noted.

 

The Chair of the Clinical and Care Governance Committee, Sarah Compton Bishop, highlighted some points for awareness including updates on the CAMHS action plan and common themes around recruitment and outstanding vacancies, and violence and aggression incidents.

 

 

The Minutes of the meeting of the Finance and Policy Committee held on 19 March 2021 were noted.

The Action Note of the Strategic Planning Group held on 4 March 2021 was noted.

Report by Chief Officer

The Board gave consideration to a report from the Chief Officer covering a range of issues under the following headings Extension of Guardian Service; Mid Argyll Midwifery Team, A Big Thank You to all vaccinators; Mid Argyll Hospital Receives Donation; Drone Delivery Flights in Argyll and Bute; and Lorn & Islands Hospital receives Generous Donations.

 

The Chief Officer provided a verbal update advising of the Day of Reflection which had taken place on 23 March 2021 and took the opportunity to commend all staff and the Board for their ongoing commitment and support throughout the Covid-19 pandemic.

 

Decision

 

The Integration Joint Board noted the content of the report by the Chief Officer.

 

(Reference:  Report by Chief Officer dated 31 March 2021, submitted)

Kevin McIntosh joined the meeting at this point.

 

Report by Business Improvement Manager

The Board gave consideration to a report noting changes in membership and roles within the IJB and the interim arrangements during the period of recruitment for the Chief Officer.

 

The Head of Customer Support Services provided a verbal update advising that the Appointments Panel held on 25 March 2021 had taken the difficult decision not to appoint to the post of Chief Officer.  She advised that George Morrison would fill the post on an interim basis from 1 April 2021 and that consultation would take place between the two Chief Executives, the Head of HR and OD, Head of Customer Support Services and trade unions to review options for a good interim arrangement.

 

Decision

 

1.    Noted transition of the chair.

2.    Noted the contribution of members who are moving on and offer thanks and welcome new members.

3.    Approved the appointment of Graham Bell to the Finance and Policy Committee and Susan Ringwood to the Audit and Risk Committee.

4.    Noted interim arrangements for the Chief Officer.

5.    Noted status of recruitment to carer and public representation.

 

(Reference:  Report by Business Improvement Manager dated 31 March 2021, submitted)

Dr Rebecca Helliwell joined the meeting at this point advising that her attendance at the meeting would be intermittent due to required attendance at other meetings that afternoon.

 

Report by Director of HR and OD

The Board gave consideration to the Culture Update report that had been presented to the NHS Highland Board on 30 March 2021.

 

Decision

 

The Integration Joint Board noted the content of the report.

 

(reference:  Report by Head of HR and OD dated 30 March 2021, submitted)

Report by Head of Customer Support Services

The Board gave consideration to a report focusing on how staff governance supported the HSCP priorities and met the staff governance standard.  The report covered financial quarter 3 (October to December 2020) and the activities of the Human Resources and Organisational Development teams.

 

Decision

 

The Integration Joint Board –

 

1.    Noted the content of this quarterly report on the staff governance performance in the HSCP

2.    Took the opportunity to ask any questions on people issues that may be of interest or concern;

3.    Endorsed the overall direction of travel, including future topics that they would like further information on.

 

(Reference:  Report by Head of Customer Support Services dated 31 March 2021, submitted)

Report by Director of HR and OD

The Board gave consideration to a report providing an update on the progress made with the implementation of the Whistleblowing Standards across NHS Highland which were due to come into effect on 1 April 2021.

 

Decision

 

The Integration Joint Board noted the content of the report.

 

(Reference:  Report by Head of HR and OD dated 30 March 2021, submitted)

Fiona Broderick left the meeting at this point to attend another engagement.

 

 

Report by Associate Director of Public Health

The Board gave consideration to a report reviewing the work of public health in Argyll and Bute relating to Covid-19.  The report built on accounts provided in earlier reports and presented the timeliest update as possible on how the pandemic was unfolding in Argyll and Bute as well as the improved response, in terms of timely access to testing and clinical management.

 

Decision

 

The Integration Joint Board noted the current status update in terms of –

 

1.    Distribution of infection rates in Argyll and Bute community.

 

2.    Covid-19 testing in Argyll and Bute community.

 

3.    Covid-19 vaccination in Argyll and Bute community.

 

4.    Support to Argyll and Bute community during the peak of Covid-19 pandemic and its adaptation to the new response phases.

 

(Reference:  Report by Associate Director of Public Health dated 31 March 2021, submitted)

 

 

Reports by Head of Finance and Transformation

Kevin McIntosh left the meeting during consideration of the following item of business to attend another engagement.

 

Fiona Broderick re-joined the meeting during consideration of the following item of business.

 

 

The Board gave consideration to a report providing a summary of the financial position of the Health and Social Care Partnership as at 28 February 2021.  The report included the Covid-19 funding announced on 5 February 2021 for both Health and Social Work.

 

Decision

 

The Integration Joint Board –

 

1.    Noted the forecast outturn position for 2020-21 is a forecast underspend of £2.016m as at 28 February 2021 and that there is a year to date underspend of £4.055m as at the same date. 

 

2.    Noted the above position includes provision for Scottish Government assistance with non-delivery of savings due to Covid-19.

 

3.    Noted that £2.65m is included in Social Work annual budget and forecasted expenditure which relates to funding from Scottish Government and is intended to be carried forward into next year.  Also there is £0.8m in Health reserves similarly expected to be carried forward in relation to Covid funding, as well as £1.6m new allocations received this month for Primary Care Improvement Fund (PCIF - £1.418m) and Action 15 of the Mental Health Strategy (£217k).

 

(Reference:  Report by Head of Finance and Transformation dated 31 March 2021, submitted)

 

The Board gave consideration to a report providing an overview of the Health and Social Care partnership’s Covid-19 mobilisation costs and its future cost planning for living and operating with Covid-19.  The report provided a snapshot of the financial estimates of the costs of dealing with the Covid-19 response.  The cost estimates, which were updated on a regular basis were subject to considerable uncertainties.

 

Decision

 

The Integration Joint Board –

 

1.    Noted the details provided in relation to Covid-19 response and associated mobilisation plan costing for 2020-21 and subsequent years.

 

2.    Acknowledged the uncertainties in the cost elements submitted and around Covid-19 recovery funding in the future.

 

3.    Noted that the Scottish Government has in principle approved all mobilisation plans, but that approval for individual cost lines has not yet been received.

 

4.    Noted that any excess funding received must be carried forward as an earmarked reserve at the year end to be used against Covid costs next year.

 

(Reference:  Report by Head of Finance and Transformation dated 31 March 2021, submitted)

 

The Board gave consideration to a report summarising the budget outlook covering the period 2021-22 to 2023-24.  The report was an update to the budget outlook report presented to the IJB on 27 January 2021.

 

Decision

 

The Integration Joint Board –

 

1. Noted the current estimated budget outlook report for the period 2021-22 to 2023-24.

 

2. Noted that there was a separate report on the agenda detailing savings options to deliver a balanced budget in 2021-22.

 

(Reference:  Report by Head of Finance and Transformation dated 31 March 2021, submitted)

 

The Board gave consideration to a report providing an updated assessment of the financial risks identified for the Health and Social Care Partnership for the year 2021/22.

 

Decision

 

The Integration Joint Board –

 

1.    Noted the updated financial risks identified for the Health and Social Care Partnership.

 

2.    Noted there are continuing uncertainties around Covid costs and funding which were described in more detail in a separate report.

 

3.    Noted that financial risks would continue to be reviewed and monitored on a two monthly basis and reported to the Board.

 

(Reference: Report by Head of Finance and Transformation dated 31 March 2021, submitted)

 

The Chair ruled and the Board agreed to take a 5 minute comfort break from 2.55pm.  The meeting reconvened at 3.00pm.

 

The Board gave consideration to a report summarising the responses received to the online budget consultation that had been launched on 22 January 2021 for a 4 week period.

 

Decision

 

The Integration Joint Board noted the findings from the Budget Consultation and agreed to ensure these are fed into considerations when discussing the separate report on the agenda detailing savings options to deliver a balanced budget in 2021-22. 

 

(Reference:  Report by Head of Finance and Transformation dated 31 January 2021, submitted)

The Board gave consideration to a report outlining the work undertaken to ensure that due regard was given to equalities, islands and Fairer Scotland Duty in the decision making in relation to budget savings.  The report presented a strategic Equality and Social-Economic Impact Assessment (EQIA) for the savings programme to advise on overall impact.

 

Decision

 

The Integration Joint Board –

 

1.    Noted the findings from the summary Equality and Social-Economic Impact Assessment (EQIA) and agreed to take these into consideration when discussing the savings options to deliver a balanced budget in 2021-22.

 

2.    Noted that the EQIA relating to transfer of clients from an in house run care home which was no longer fit for purpose to private sector care home within same locality was reported on separately in the Care Homes and Housing policy paper.

 

(Reference:  Report by Head of Finance and Transformation dated 31 March 2021, submitted)

 

The Board gave consideration to a report presenting savings proposals identified by the Strategic Leadership Team in order to deliver a balanced budget in 2021-22.

 

Motion

 

The Integration Joint Board is asked to:

·         Approve the management/operational savings at Appendix 1 with the removal of saving 2122-48 amounting to £3.646m in 2021-22 and £2.676m in 2022-23; noting that savings 2122-16 and 2122-57 had already been implemented.

 

·         Approve the policy savings at Appendix 2 removing savings 2122-13 and 2122-14 amounting to £561k in 2021-22 and £782k in 2022-23.

 

·         Approve the removal of £85k previously agreed savings – reference 1920-32 £44.5k  and 1920-33 £40.7k both relating to the management restructure as set out at 3.2.6.

 

·         Approve the proposed investment in financial sustainability totalling £505k in 2021/22 and 2022/23 set at 3.3.6 and the proposed extension of the existing investment of £330k for a further year in 2022-23 as set out at 3.3.7.

 

·         Note that in approving the above savings and financial investment this will deliver a balanced budget in 2021-22.

 

·         Note the financial consequences of the actions set out at paragraph 3.13 in the Care Homes and Housing paper for 2022-23 and beyond.

 

·         Instruct the Chief Officer to accept the funding from NHS Highland and Argyll and Bute Council and issue formal Directions (see drafts at Appendix 3) delegating resources back to the Partners.

 

·         Note the high level timetable for the budget preparation 2022-23 set out at 3.5.1. 

 

·         Request that papers be brought back to the IJB detailing further work carried out on 2122-48 and 2122-14 for further consideration by the Board.

 

Moved by Councillor Kieron Green, seconded by Councillor Robin Currie.

 

Amendment

 

To approve the terms of the Motion but with the retention of saving 2122-48.

 

Moved by Councillor Gary Mulvaney, seconded by Gaener Rodger.

 

As the meeting was being held on a virtual basis, the vote required to be taken by calling the roll as it was the only practical method of voting.  This required the suspension of Standing Order 15.2 which was agreed by the Board.

 

Having previously declared an interest in this item of business, Sarah Compton Bishop abstained from voting.

 

The vote was taken by calling the roll and Members voted as follows –

 

Motion                                                Amendment

Councillor Kieron Green                     Councillor Gary Mulvaney

Councillor Robin Currie                      Jean Boardman

Councillor Sandy Taylor                     Gaener Rodger

 

The Motion received 3 votes and the Amendment received 3 votes.

 

As there was an equality of votes and because the meeting was being held on a virtual basis, it was agreed by the Board to suspend Standing Order 15.3 to enable the Chair to have a casting vote.

 

In exercising his casting vote the Chair voted for the Motion and therefore the Motion was carried by 4 votes to 3 and became the decision of the Board.

 

Decision

 

The Integration Joint Board –

 

1.    Approved the management/operational savings at Appendix 1 with the removal of saving 2122-48 amounting to £3.646m in 2021-22 and £2.676m in 2022-23; noting that savings 2122-16 and 2122-57 had already been implemented.

 

2.    Approved the policy savings at Appendix 2 removing savings 2122-13 and 2122-14 amounting to £561k in 2021-22 and £782k in 2022-23.

 

3.    Approved the removal of £85k previously agreed savings – reference 1920-32 £44.5k  and 1920-33 £40.7k both relating to the management restructure as set out at 3.2.6.

 

4.    Approved the proposed investment in financial sustainability totalling £505k in 2021/22 and 2022/23 set at 3.3.6 and the proposed extension of the existing investment of £330k for a further year in 2022-23 as set out at 3.3.7.

 

5.    Noted that in approving the above savings and financial investment this will deliver a balanced budget in 2021-22.

 

6.    Noted the financial consequences of the actions set out at paragraph 3.13 in the Care Homes and Housing paper for 2022-23 and beyond.

 

7.    Instructed the Chief Officer to accept the funding from NHS Highland and Argyll and Bute Council and issue formal Directions (see drafts at Appendix 3) delegating resources back to the Partners.

 

8.    Noted the high level timetable for the budget preparation 2022-23 set out at 3.5.1.

 

9.    Requested that papers be brought back to the IJB detailing further work carried out on 2122-48 and 2122-14 for further consideration by the Board. 

 

(Reference:  Report by Head of Finance and Transformation dated  31 March 2021, submitted)

 

Report by Head of Strategic Planning and Performance

The Board gave consideration to a report providing an update on the impact on service performance with regards to the Covid-19 pandemic and the progress made with regard to remobilising Health and Social Care Services in Argyll and Bute.

 

Decision

 

The Integration Joint Board –

 

1.    Noted the continued suspension of reporting against the HSCP Health & Wellbeing Outcome Indicators.

 

2.    Noted the current Covid19 activity within Argyll & Bute, NHS Highland and Greater Glasgow and Clyde.

3.    Noted the HSCP performance progress regarding remobilisation of activity in line with NHS Highland performance target for 2020/21 agreed with Scottish Government to 70%-80% of 2019/20 activity.

4.    Noted the extension to the reporting timescales for the Annual Performance Report and review guidance with regards to the Strategic Commissioning Plan and Integration Scheme.

(Reference:  Report by Head of Planning and Performance dated 31 March 2021, submitted)

Report by Head of Older Adults Service and Community Hospitals

The Board gave consideration to a report summarising the progress to date of the Care Home and Housing Programme Board.  The report provided context  in the work previously undertaken and gave details of the approach going forward.

 

Decision

 

The Integration Joint Board –

 

1.    Approved the Programme Management Approach to progressing the Care Home and Housing Transformation work.

 

2.    Approved the work stream approach and the short and longer term priorities set out at 3.3 of the submitted report.

 

3.    Recognised the importance of engagement as outlined at 3.6 of the submitted report.

 

4.    Approved the options appraisal scoring framework set out at 3.10 to 3.12 of the submitted report.

 

5.    Agreed to delegate authority to the Finance & Policy Committee to approve the outcome of the options appraisal.

 

6.    Agreed the approach to the financial implications set out at 3.13 of the submitted report.

 

7.    Noted the progress of the Care Home and Housing Programme Board detailed within the report.

 

(Reference:  Report by Head of Older Adults and Community Hospitals dated 31 March 2021, submitted)

 

Report by Chief Officer

The Board gave consideration to a report presenting the Argyll and Bute Suicide Prevention Action Plan on behalf of the Suicide Prevention Group.  The Plan sought to address suicide and the impact of suicide within communities in Argyll and Bute enabling a Suicide Safer Community reducing stigma ad developing support.  The Plan also sought to maximise resource and approach between agencies and disciplines all working towards a common goal of suicide prevention.

 

Decision

 

The Integration Joint Board –

 

1.    Noted the issues raised in the action plan and impacts on Argyll & Bute communities.

2.    Endorsed the Action Plan and provided the accountability for delivery.

 

(Reference:  Report by Chief Officer dated 31 March 2021, submitted)

Report by IJB Standards Officer

The Board gave consideration to a report providing information on an amendment now in force as of 17 March 2021 laid before the Scottish parliament which includes Integration Joint Boards as Category 1 Responders under the Civil Contingencies Act 2004.  The report also provided a summary of the consultation and outline of the duties.

 

Decision

 

The Integration Joint Board –

 

1.    Noted the content of the report and the amendment to The Civil Contingencies Act 2004 (Amendment of List of Responders) (Scotland) Order 2004.

 

2.    Agreed to accept responsibility for compliance with the duties as described.

 

(Reference:  Report by IJB Standards Officer dated 31 March 2021, submitted)

 

Report by IJB Standards Officer

The Board gave consideration to a report advising that the revised Health and Social Care Integration Scheme had been signed off by the Cabinet Secretary for Health and Sport and that arrangements could now be put in place by NHS Highland and Argyll and Bute Council to publish the document.

 

Decision

 

The Integration Joint Board noted that the Integration Scheme had been approved by the Scottish Government and that arrangements would now be put in place by the two parent bodies to publish the document.

 

(Reference:  Report by IJB Standards Officer dated 31 March 2021, submitted)

16 June 2021 at 1.00pm via Skype

The date of the next meeting was noted as 16 June 2021.

The Chair recognised that this was the last Board meeting for both Joanna MacDonald and Gaener Rodger, and he thanked them both for the valuable contribution  they had made to both the Board and to the HSCP.

 

Sarah Compton Bishop advised that this was Councillor Kieron Green’s last IJB meeting as Chair before she resumed the role.  She thanked Kieron for his contribution as Chair recognising the challenges he had faced as Chair of the Board over the previous two years.

 

The Chair thanked everyone for their attendance at the meeting and expressed his best wishes to Sarah in her role as Chair.