Councillors Iain McMillan, Michael Holmes, Jacqueline Henry and Derek Bibby (all Renfrewshire Council); Donny Lyons, Donald Sime, Morag Brown and John Brown (all Greater Glasgow & Clyde Health Board); Karen Jarvis (Registered Nurse); Stephen McLaughlin (Registered Medical Practitioner (GP)), Alex Thom (Registered Medical Practitioner (non-GP)); Liz Snodgrass (Council staff member involved in service provision); David Wylie (Health Board staff member involved in service provision); Helen McAleer (unpaid carer residing in Renfrewshire); Alan McNiven (third sector representative); John Boylan (trade union representative for Council staff); Graham Capstick (trade union representative for Health Board staff); David Leese, Chief Officer and Sarah Lavers, Chief Finance Officer (both Renfrewshire Health and Social Care Partnership) and Dorothy Hawthorn (Renfrewshire Council) (substitute for Peter Macleod, Chief Social Work Officer, Renfrewshire Council).

Councillor Iain McMillan, Chair, presided.

Anne McMillan, Head of Resources, Iain Beattie, Head of Adult Services, Lynn Mitchell, Managing Solicitor (Contracts/Conveyancing), Karen Campbell, Assistant Chief Internal Auditor, Frances Burns, Health and Social Care Integration Programme Manager, Gayle Fitzpatrick, Service Planning & Policy Development Manager, Elaine Currie, Senior Committee Services Officer and Filoretta Gashi, Joint Strategic Commissioning Graduate Intern (all Renfrewshire Council); Fiona Mackay, Head of Planning & Health Improvement, Katrina Philips, Head of Mental Health, Addictions and Learning Disabilities and James Higgins, Health and Social Care Integration Project Officer (all Renfrewshire Health and Social Care Partnership).

The Chair intimated that there was an additional item in relation to a report by the Chief Internal Auditor relative to Health and Social Care Integration - Financial Assurance Audit which had not been included in the notice calling the meeting. The Convener, being of the opinion that the item, which is dealt with at item 14 of this Minute, was urgent in view of the need to consider the matter timeously authorised its consideration.

In terms of Standing Order 4.1 (iii), the Chair intimated that he proposed to alter the order of business to facilitate the conduct of the meeting by considering items 14 and 15 of the agenda after the additional item of business.

The Chief Internal Auditor submitted a report relative to the Internal Audit Report on the IJB Health and Social Care Integration Financial Assurance Audit, a copy of which formed the appendix to the report.

The report intimated that as part of the 2015/16 Council Internal Audit Plan a review had been undertaken to provide members with an opinion on the financial governance and financial assurance undertaken in the determination of the Council’s social care budgets to be integrated.

The Scottish Government established the Integrated Resources Advisory Group (IRAG) to develop professional guidance in relation to financial matters including the framework for financial governance and financial assurance. The purpose of the audit review had been to ensure that a robust process had been followed to establish the financial governance arrangements for the IJB and that the financial assurance guidance prepared by IRAG had been followed in relation to establishing the budgets to be transferred from Renfrewshire Council to the IJB.

Internal Audit was able to provide a reasonable level of assurance over financial governance and financial assurance relating to Renfrewshire Council and its responsibilities to the IJB. Moving forward there would need to be continued monitoring of the financial risks that had been identified through the due diligence process. Risk registers in this regard should be comprehensive, transparent and regularly monitored.

The outcome of the assurance work undertaken by the internal auditor for NHSGG&C, which had been presented to the NHSGG&C Board and which facilitated the requirement for Renfrewshire Council and NHSGG&C to prepare a joint report for the IJB, formed the annex to the appendix to the report.

DECIDED: That the content of the Internal Audit Report be noted.

Stephen Cruickshank (service user residing in Renfrewshire) and Peter Macleod, Chief Social Work Officer (Renfrewshire Council).

Dr Donny Lyons declared an interest in relation to item 7 of the agenda as he was a member of the Equality and Human Rights Commission Scotland Committee. He did not consider it necessary to leave the meeting.

The Minute of meeting of the Integration Joint Board (IJB) held on 15 January 2016 was submitted.

DECIDED: That the Minute be approved.

The Chief Finance Officer submitted a report relative to the revenue and capital budget positions from 1 April 2015 to 8 January 2016 for Social Work and from 1 April 2015 to 31 January 2016 for the Health Board.

DECIDED:

(a) That the financial position to date be noted; and

(b) That the progress made on the financial planning process for 2016/17 be noted.

The Chief Finance Officer submitted a report relative to the Renfrewshire IJB Reserves Policy, a copy of which formed the appendix to the report.

The report intimated that the policy explained the purpose of holding a reserve; identified the principles to be employed by the IJB in assessing the adequacy of the reserves; detailed the role of the Chief Finance Officer with regards to reserves; indicated how frequently the reserves would be reviewed and set out arrangements relating to the creation, amendment and use of the reserves and balances.

Section 106 of the Local Government (Scotland) Act 1973 as amended, empowered the IJB to hold reserves which must be accounted for in the financial accounts. The IJB was entitled to hold reserves in order to meet the needs of Renfrewshire HSCP. As the IJB did not have any capital assets of its own it could only hold two types of reserves, a General Reserves and a Renewal and Repair Reserves. This position would change if the IJB held capital assets in the future.

A discussion took place relative to placing a limit on the level of reserves; delegating authority to the Chief Finance Officer and whether decisions regarding the use of reserves would be required to be made by the IJB. It was proposed that consideration of this matter be continued and that the Chief Finance Officer consider all the points raised and submit a further report to the next meeting of the IJB. This was agreed

DECIDED: That consideration of this matter be continued and that the Chief Finance Officer consider all the points raised and submit a further report to the next meeting of the IJB.

The Chief Internal Auditor submitted a report relative to the IJB’s risk based internal audit plan for 2016/17 in line with the requirements of the Public Sector Internal Audit Standards, a copy of which formed the appendix to the report.

The plan set out a resource requirement of 35 days, including assurance work, time for ad-hoc advice and planning and reporting. The allocation of internal audit resources was sufficient to allow emerging priorities and provide adequate coverage of governance, risk management and internal control to inform the annual assurance statement. The plan might be subject to amendment during the course of the year due to the emergence of issues of greater priority or unforeseen circumstances and these changes would be reported to the Audit Committee.

DECIDED:

(a) That the internal audit plan for 2016/17 be approved; and

(b) That it be noted that the internal audit plan would be shared with the local authority and health board.

The Chief Officer submitted a report relative to the Renfrewshire HSCP Performance Management Report 2015/16.

The report intimated that a performance framework was required to ensure that the HSCP operated with informed, effective and efficient management of services and to provide a coherent picture of the outcomes achieved by the HSCP.

The report provided an update on performance as at quarter three on the agreed performance scorecard for 2015/16, which formed the appendix to the report, together with an update on the further work to be undertaken to develop a Performance Management Framework for 2016/17.

A development session had been arranged for early May 2016 and this would provide an opportunity for members to discuss and agree options for the 2016/17 Performance Management Framework to ensure it met the IJB’s requirements.

DECIDED:

(a) That the quarter three update on the 2015/16 performance scorecard, which formed the appendix to the report, be noted;

(b) That the performance update for year-end be submitted to the next meeting of the IJB;

(c) That it be noted that the indicators in the scorecard were reported at a number of frequencies and that information might not always be available at the end of a reporting period;

(d) That the Outcomes and Performance Management Integration Workstream take forward the development of the HSCP 2016/17 Performance Management Framework; and

(e) That it be noted that further development work would be undertaken with IJB members and HSCP senior managers and that the Performance Management Framework for 2016/17 would be submitted to the next meeting of the IJB.

The Chief Officer submitted a report relative to membership of the Audit Committee. The report intimated that at the meeting of the IJB held on 20 November 2015 the establishment of an Audit Committee had been approved together with the terms of reference and standing orders.



















In line with the approved terms of reference, the report proposed that the four health board voting members be invited to nominate two of their number to sit on the Audit Committee and also be invited to propose which of the two nominated members was to be Chair of the Audit Committee; the four council voting members be invited to nominate two of their number to sit on the Audit Committee; and the non-voting members be invited to indicate if they wished to be considered for nomination to sit on the Audit Committee. To avoid any conflict of interest the Chief Officer and the Chief Finance Officer should not be members of the Audit Committee.



The agreed terms of reference for the Audit Committee stated that it shall meet at least three times a year and the report proposed that authority be delegated to the Chief Officer, in consultation with the Chair and Vice Chair, to make the necessary arrangements to schedule these meetings and to arrange support for the Audit Committee and its members. This was agreed.



DECIDED:



(a) That the arrangements for the establishment of an Audit Committee be noted;



(b) That it be noted that Dr Donny Lyons and Morag Brown would be the health board’s representatives on the Audit Committee and that Dr Donny Lyons be appointed as Chair of the Audit Committee;



(c) That it be noted that Councillors Michael Holmes and Derek Bibby would be the council’s representatives on the Audit Committee;



(d) That it be noted that Alan McNiven would be one of the non-voting members on the Audit Committee;



(e) That the other non-voting members consider nomination to sit on the Audit Committee and advise the Chief Officer accordingly; and



(f) That authority be delegated to the Chief Officer, in consultation with the Chair and Vice Chair, to make the necessary arrangements to schedule meetings of the Audit Committee and to arrange support for the Audit Committee and its members.





DECLARATION OF INTEREST



Dr Donny Lyons having declared an interest in the following item of business remained in the meeting.

The Chief Officer submitted a report relative to Renfrewshire HSCP Mainstreaming Equality Report.

The report intimated that in April 2015 the Scottish Government added IJBs to Schedule 19 of the Equality Act 2010 and the Equality Act 2010 (Specific Duties) (Scotland) Amendment Regulations 2015. This required IJBs to publish a set of equality outcomes and report on progress made to mainstream the equality duty by 30 April 2016.

Renfrewshire HSCP had produced a mainstreaming equality report including a set of equality outcomes to meet the requirements of the legislation. Initial publication of the mainstreaming equality report, which formed the appendix to the report, would be completed by 30 April 2016.

DECIDED:

(a) That the Renfrewshire HSCP Mainstreaming Equality Report be approved; and

(b) That it be noted that the publication date of 30 April 2016 had been set by statute as had the requirement to publish update reports every two years thereafter.

The Chief Officer submitted a report relative to the Renfrewshire HSCP Organisational Development and Service Improvement Strategy 2016/19, a copy of which formed Appendix 1 to the report.

The report intimated that Renfrewshire HSCP embraced the commitments detailed within Renfrewshire Council’s ‘A Better Future, A Better Council’ and NHS GG&C’s ‘Workforce Plan’ by ensuring that staff involved in health and social care service delivery had the necessary training, skills and knowledge to provide the people of Renfrewshire with the highest quality services.

The Organisational Development and Service Improvement Strategy would focus on three key objectives that would support the workforce to be committed, capable and engaged in person centred, safe and effective service delivery, being the development of a healthy organisational culture; delivering a clear approach to organisational development and service improvement; and delivering a workforce plan for tomorrow’s workforce. The strategy would be subject to annual review and would take account of future changes in corporate priorities and objectives, legislative and regulatory changes and reflect on-going changes to the profile of the workforce, their development needs and succession planning as services changed to meet service demand.

With this strategy in place, a year on year Organisational Development and Service Improvement Implementation Plan would be developed which would provide detail on how the strategy’s three key objectives would be delivered.

The Renfrewshire HSCP Staff Partnership Agreement, which formed Appendix 2 to the report, provided a framework for partnership working between Renfrewshire HSCP, trade unions and professional organisations recognised within the council and health board.

DECIDED:

(a) That the Renfrewshire HSCP Organisational Development and Service Improvement Strategy 2016/19 be approved;

(b) That it be noted that this strategy would be subject to annual review which would be shared with the IJB; and

(c) That it be noted that regular updates on the progress against the three key objectives would be submitted to future meetings on the IJB.

Under reference to item 16 of the Minute of the meeting of the IJB held on 18 September 2015 the Chief Officer submitted a report relative to an update on the progress made in implementing the Quality, Care and Professional Governance Framework.

Appendix 1 to the report detailed the progress made to ensure that effective clinical and care governance arrangements were in place from 1 April 2016; Appendix 2 to the report set out the governance structure which established the Renfrewshire HSCP Executive Governance Group, the Renfrewshire HSCP Professional Executive Governance Group, the Renfrewshire HSCP Service Pods - Locality Services, the Renfrewshire HSCP Mental Health, Addictions and Learning Disability Services and the Renfrewshire Chief Social Work Officer (CSWO) Professional Group; and Appendix 3 to the report detailed the remit and membership of these groups.

DECIDED: That the progress made in implementing the Quality, Care and Professional Governance Framework by 1 April 2016 be noted.

Under reference to item 9 of the Minute of the meeting of the IJB held on 20 November 2015 the Chief Officer submitted a report relative to the Renfrewshire HSCP Participation, Engagement and Communication Implementation Plan for 2016/19, a copy of which formed the appendix to the report.

DECIDED:

(a) That the progress made in implementing the Renfrewshire HSCP Participation, Engagement and Communication Implementation Plan for 2016/19 be noted; and

(b) That it be noted that the Implementation Plan would be subject to annual review which would be shared with the IJB.

The Chief Officer submitted a report relative to the findings of the independent review of the governance arrangements for public protection in Renfrewshire.

The report intimated that in recognition of the implications of changes in the organisation landscape, the Renfrewshire Chief Officers Group for Public Protection had commissioned an independent review of the oversight arrangements for public protection including the design and strategic oversight role of the Chief Officers Group, the role of the other strategic groups and committees in supporting the Chief Officers Group in its leadership and scrutiny roles, and the role and design of the tactical and operational groups which supported them.



The review had been undertaken between August and November 2015 by a former chief social work officer and experienced independent adult and child protection committee chair. The report on the review was completed in December 2015 and made a number of key recommendations regarding the design and function of the Chief Officers Group as well as additional recommendations regarding strategic and operational groups. The report and recommendations were considered by the Chief Officers Group at its meeting held on 22 January 2016 and, subject to a small number of amendments detailed in the report, had been agreed.

The report submitted to the meeting of Renfrewshire Council’s Leadership Board held on 17 February 2016 formed the appendix to the report and set out the context of the review and the key findings and recommendations arising from it. In particular it noted that from 1 April 2016 the Alcohol and Drugs Partnership (ADP) and the Gender Based Violence (GBV) Strategy Group would report through the IJB. The report also made a recommendation that chairmanship of the ADP and the GBV Strategy Group reflect the new delegated responsibilities of the IJB through the HSCP Chief Officer subject to the respective agreement of these multi-agency groups.

DECIDED:

(a) That the findings of the independent review of the governance arrangements for public protection in Renfrewshire be noted;

(b) That the updates to the review recommendations agreed by the Chief Officers Group at its meeting held on 22 January 2016, as detailed in the appendix to the report, be noted;

(c) That it be noted that from 1 April 2016 the ADP and the GBV Strategy Group would report through the IJB to reflect its new delegated responsibilities for addictions and gender based violence/domestic abuse services;

(d) That the chairmanship for the ADP and the GBV Strategy Group be updated to reflect the new delegated responsibilities of the IJB through the HSCP Chief Officer subject to the respective agreement of these multi-agency groups; and

(e) That it be noted that the Chief Officer, in liaison with the ADP and the GBV Strategy Group, would recommend future reporting arrangements for both the ADP and the GBV Strategy Group for consideration at the next meeting of the IJB.

The Chief Officer submitted a report relative to the current status and planned activity to provide assurance that all the necessary processes, policies and plans were in place as required to allow local implementation of integrated health and social care services by 1 April 2016 in terms of the Public Bodies (Joint Working) (Scotland) Act 2014.







The report intimated that whilst overall good progress was being achieved, the supporting 2016/17 delegated budget to deliver the IJB’s Strategic Plan and supporting services from 1 April 2016 had not yet been agreed. The 2016/17 budget setting process for delegated health functions had not yet been approved by NHSGG&C and it was possible that the IJB’s delegated budget would not be finalised by 1 April 2016. The Financial Due Diligence Update report, considered at item 13 of this Minute, set out the risks which this delay created for the IJB.

The report also updated the IJB on the advice note issued by the Standards Commission for Scotland on the requirement for all devolved public bodies to appoint a Standards Officer, a copy of which formed Appendix 2 to the report. The report proposed that Renfrewshire Council’s Head of Corporate Governance be appointed to the role of Standards Officer for the IJB. This was agreed.

DECIDED:

(a) That the progress being achieved to ensure all the necessary arrangements would be in place to allow local implementation of integrated health and adult social care services, in terms of the Public Bodies (Joint Working) (Scotland) Act 2014, be noted;

(b) That the position regarding the IJB’s delegated budget be noted; and

(c) That Renfrewshire Council’s Head of Corporate Governance be appointed to the role of Standards Officer for the IJB, subject to approval of the Standards Commission for Scotland.

The Chief Finance Officer submitted a report relative to the due diligence process undertaken to seek assurances that the budgets for 2016/17 being transferred from Renfrewshire Council and NHSGG&C were adequate and that the makeup of the budgets and any underlying risks and assumptions were mutually understood.

The report intimated that the due diligence process ensured a consistency in approach for Chief Officers and Chief Finance Officers in providing a transparent, evidence-based methodology to identify continuing pressures, demands and associated risks in relation to the delegated functions. This allowed the identification of any relevant and necessary management action to be taken including potential baseline funding adjustments.

A comprehensive financial due diligence process had been completed for the adult social care budget, being delegated by Renfrewshire Council to the IJB from 1 April 2016, which concluded that the 2016/17 budget was sufficient to deliver on the outcomes highlighted within the Strategic Plan subject to effective risk mitigation and the successful delivery of efficiency initiatives detailed with the report.

At this stage, the NHSGG&C budget for 2016/17 had not yet been formally set and the plans to meet the identified financial pressures were still being developed. The Chief Finance Officer was unable to complete her financial due diligence on the proposed NHS budget transfer until a budget had been set by NHSGG&C.




The Scottish Government issued guidance on financial resources for integration authorities on 14 March 2016 which highlighted the health board’s responsibilities in relation to confirming its final budget allocation to IJBs for 2016/17 and a copy of this letter formed Appendix 1 to the report. The Chief Executive, NHSGG&C issued a letter dated 14 March 2016 to the six NHSGG&C HSCP Chief Officers outlining its 2016/17 financial planning and budget setting process and provided an indicative allocation of uplift and cost pressures for each IJB and a copy of this letter formed Appendix 2 to the report.

The Chief Finance Officer’s report set out recommendations and advice to the IJB going into 2016/17 in light of the financial uncertainty and the key areas of risk this represented for the IJB.

DECIDED:

(a) That the financial due diligence work completed by the Chief Finance Officer in relation to the social care budget, being delegated from Renfrewshire Council to the IJB from 1 April 2016, be noted;

(b) That the Chief Finance Officer’s assurances in relation to the sufficiency of the social care budget to be delegated, subject to effective risk mitigation and the successful delivery of efficiency initiatives detailed in the report, be noted;

(c) That the current incomplete position with regards to the financial due diligence work undertaken by the Chief Finance Officer in relation to the health budget, being delegated from NHSGG&C to the IJB from 1 April 2016, be noted;

(d) That the terms of the letter from the Scottish Government dated 14 March 2016 in relation to financial resources for Integration Authorities, as detailed in Appendix 1 to the report, be noted;

(e) That the contents of the letter from the Chief Executive of NHSGG&C which outlined the health boards 2016/17 financial planning and budget setting process, as detailed in Appendix 2 to the report, be noted;

(f) That pending the final health budget being agreed by NHSGG&C, the advice from the Chief Finance Officer that the IJB should assume that the NHSGG&C Board would fund the full cost of delegated health functions from 1 April 2016, net of any agreed reductions, be approved. This should be treated as an interim position pending the NHSGG&C Board finalising its budget for 2016/17;

(g) That the IJB Chairman seek written confirmation from NHSGG&C, on behalf of the IJB, that they will fund this interim position based on the assumptions outlined in paragraph 6.7 of the report;

(h) That pending approval of the final 2016/17 health budget to be delegated by NHSGG&C, the IJB provide formal assurance to Renfrewshire Council that resources being transferred for delegated adult social care functions would not be utilised to offset any resource shortfall or unacceptable risk position identified through the due diligence process for the provision of delegated health services. This assurance would not preclude the IJB making any future service or resource changes where such decisions were in line with the direction of travel as set out in the IJB’s Strategic Plan;


(i) That the Chief Officer issue Interim Directions to the NHSGG&C Chief Executive, consistent with the assumed health service’s position as detailed in paragraph 6.7 of the report;

(j) That delegated authority be granted to the Chief Officer to issue Interim Directions to Renfrewshire Council’s Chief Executive, consistent with Renfrewshire Council’s position as detailed in paragraph 6.3 of the report;

(k) That the Chief Officer continue to work with the Health Board Corporate Management Team and others to identify savings schemes and changes on a NHSGG&C whole system basis that reflected viable cost reductions to support the Health Board achieve its budget position for 2016/17;

(l) That the Chief Officer advise the IJB of the operational implications of any viable and agreed savings and the impact to current service delivery and performance levels; and

(m) That the Chief Finance Officer submit a report to a future meeting of the IJB completing the financial due diligence process noting any risks and caveats identified and appropriate mitigation required and the final 2016/17 Financial Plan once NHSGG&C had agreed the final 2016/17 health budget to be delegated to the IJB.

The Chief Officer submitted a report relative to the outcome of the final consultation exercise carried out on the second draft of the Strategic Plan. The updated draft Strategic Plan formed the appendix to the report.

The report intimated that the draft Strategic Plan now broadly reflected the feedback received given the wide range of responses received. A Housing Contribution Statement had been developed and was summarised in an appendix to the Plan and the Executive Summary detailed the challenges and key issues in a diagrammatic form. The case studies had been simplified to show the services which currently supported the four patients/clients and how the Strategic Plan would impact on them in the next three years.

The final Strategic Plan would be submitted to a future meeting of the IJB for approval following approval of the IJB budget for 2016/17.

DECIDED:

(a) That the consultation process detailed in the report be noted; and

(b) That the amendments to the Strategic Plan be noted.

Under reference to item 4 of the Minute of the meeting of the IJB held on 15 January 2016 the Chief Officer submitted a report relative to the progress being made to mitigate risk in relation to the activities of the IJB up to 1 April 2016.

The report detailed the progress being made to mitigate the risks identified and highlighted a programme risk in relation to agreeing the IJB’s 2016/17 delegated budget which was required to deliver the IJB’s Strategic Plan and supporting services from 1 April 2016. Renfrewshire Council’s budget setting process and adult social care budget to be delegated had been agreed on 3 March 2016. The 2016/17 budget for delegated health functions had not yet been approved by NHSGG&C and it was possible that the IJB’s 2016/17 delegated budget would not be finalised by 1 April 2016. The Chief Finance Officer’s report on financial due diligence, considered at item 14 of this Minute, set out the risks caused by this delay and provided advice to the IJB moving into 2016/17 without this financial clarity.

DECIDED:

(a) That the progress being made with regards to managing the key risks identified be noted;

(b) That the position regarding the IJB’s delegated budget and the associated risks set out in the Chief Finance Officer’s financial due diligence report be noted; and

(c) That it be noted that a report relative to the updated risk management arrangements reflecting the IJBs strategic and operational responsibilities in relation to the delivery of health and adult social care services from 1 April 2016 would be submitted to the next meeting of the IJB.

The Director of Finance & Resources, Renfrewshire Council, submitted a report relative to the timetable of meetings of the IJB up to June 2017. A further report would be submitted to a future meeting of the IJB setting out proposed meeting dates beyond June 2017.

The report intimated that following agreement with the Chair and Vice Chair it had been proposed that the next meeting of the IJB scheduled to be held on 17 June 2016 be re-scheduled to 24 June 2016. The date for the Referendum on the United Kingdom’s membership of the European Union had since been called for 23 June 2016 and it might be that the re-scheduled date for the meeting of the IJB would no longer be suitable. Members would be advised if this date required to be re-scheduled.

DECIDED:

(a) That meetings of the IJB be held on 16 September and 25 November 2016, 20 January, 24 March and 23 June 2017;

(b) That it be noted that a further report would be submitted to a future meeting of the IJB setting out proposed meeting dates beyond June 2017; and

(c) That it be noted that the next meeting of the IJB scheduled to be held on 17 June 2016 had been re-scheduled to 24 June 2016 and that this meeting may require to be further re-scheduled.


Valedictory

The Chair referred to Anne McMillan’s imminent early retirement from Renfrewshire Council and paid tribute to her service to both the Council and the IJB. On behalf of the IJB he thanked her for her contribution to the development of the IJB and wished her a long and happy early retirement.