Councillors Iain McMillan, Michael Holmes, Jacqueline Henry and Derek Bibby (all Renfrewshire Council); Dr Donny Lyons, Morag Brown, John Legg and Dorothy McErlean (all Greater Glasgow & Clyde Health Board); Karen Jarvis (Registered Nurse); Dr Christopher Johnstone (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); Alan McNiven (third sector representative); Helen McAleer (unpaid carer residing in Renfrewshire); Stephen Cruickshank (service user residing in Renfrewshire); John Boylan (trade union representative for Council staff); Graham Capstick (trade union representative for Health Board staff); David Leese, Chief Officer, Sarah Lavers, Chief Finance Officer (both Renfrewshire Health and Social Care Partnership) and Peter Macleod, Chief Social Work Officer (Renfrewshire Council).

Councillor Iain McMillan, Chair, presided.

Ken Graham, Head of Corporate Governance (Clerk), Iain Beattie, Head of Health and Social Care (Paisley), Frances Burns, Health and Social Care Integration Programme Manager and Dave Low, Senior Committee Services Officer (all Renfrewshire Council); and Fiona Mackay, Head of Strategic Planning & Health Improvement, Mandy Ferguson, Operational Head of Service and James Higgins, Health and Social Care Integration Project Officer, Jill Cram (Senior Business Support Officer), Donna Reid (ADP Lead Officer) and Janice Turnball (Senior OD Advisor) (all Renfrewshire Health and Social Care Partnership).

The Chief Finance Officer submitted a report relative to the revenue and capital budget positions from 1 April to 16 September 2016 for Social Work and from 1 April to 30 September 2016 for the Health Board, as detailed in appendices 1 and 2 to the report.  The key pressures were highlighted in sections 4 and 5 of the report. 

The report provided an update on the proposed 2016/17 savings in respect of the Health Board’s contribution to the IJB; and the implementation of the Living Wage.

The overall revenue position for the Renfrewshire Health and Social Care Partnership (HSCP) at 30 September 2016 was an overspend of £686,000, as detailed in Appendix 2 to the report, with a projected year-end adverse variance of £1.378 million. Appendix 3 to the report provided details of the adult social care financial allocation to the HSCP and Appendix 4 provided details of the health financial allocation to the HSCP.

The Chief Officer provided a presentation to the IJB detailing proposed savings to the Health Board’s contribution to the IJB in 2016/17 and advised that additional savings would be required from April 2017. Details of proposed savings to adult community services, mental health services, health improvement, children’s services’ podiatry and administrative services were included in paragraph 9.4 of the report.

Councillor Holmes, seconded by Councillor Bibby, moved that the savings proposals be not approved; that the IJB write to the Minister for Health and Sport with a request to bring forward future budget increases to cover 2016/17; and that officers submit further savings proposals to a future meeting based on the response to the Board's approach to the Minister for Health and Sport.

Dr Donny Lyons, seconded by Morag Brown, moved as an amendment that consideration of the proposed savings be continued to a future meeting of the IJB and that officers provide to that meeting further information on the impact of the savings proposals.

At this point, Councillor McMillan asked the Clerk to clarify the position in terms of the IJB’s governance. The Clerk highlighted the importance of the IJB being able to set a balanced budget and outlined a number of governance issues in relation to this. He referred to paragraph 9.4 of the IJB’s Standing Orders for Meetings which set out the repercussions of an equality of votes. He also highlighted that the report contained a total of four recommendations, only one of which related to the savings proposal.

Councillor McMillan proposed that the first three recommendations contained in the report be considered apart from the fourth recommendation which related to the savings proposal. This was agreed. The first three recommendations were then agreed unanimously.

On a vote being taken on the fourth recommendation in relation to the savings proposals, 4 members voted for the amendment and 4 members voted for the motion. There being an equality of votes and there being no casting vote available to the Chair both the motion and the amendment were not approved and recommendation 4 fell.  Members were reminded that the Integration Scheme contained a dispute resolution procedure to deal with situations where agreement cannot be reached.

DECIDED:

(a) That it be noted that the financial position to date was an overspend of £686,000 with a potential full year adverse variance of £1.378 million;

(b) That it be noted that the forecast position for the remainder of the financial year assumed the overspend position would continue unless service changes and cost reductions were achieved; and

(c) That the progress of the Living Wage Implementation Project be noted.

There were no declarations of interest intimated prior to the commencement of the meeting.

The Minute of meeting of the Integration Joint Board (IJB) held on 16 September 2016 was submitted.

DECIDED: That the Minute be approved.

The Chair provided a verbal report relative to service and site visits undertaken by him across Renfrewshire to gain a better insight and understanding of the range of services and related issues facing the IJB.

DECIDED: That the report be noted.

Under reference to item 7 of the Minute of the meeting of this Joint Board held on 16 September 2016 the Chief Officer submitted a report relative to the IJB’s first performance report for 2016/17, covering the period April to September 2016.  Appendix 1 to the report provided an indication of progress against the nine national outcomes; Appendix 2 provided a full scorecard updating all performance measures; and Appendix 3 gave detailed information in relation to two exception reports.

The report advised that 88 performance indicators were grouped under the nine national outcomes of which 54 had targets set against them. Of the 54 indicators against which targets had been set, 16 displayed a variance from target of more than 10%, 10 were within a 10% variance of target and 28 were on or above target.

John Legg referred to the number of children highlighted in the report who had been impacted by delays from assessment to appointment in terms of paediatric Speech and Language Therapy. He proposed that an update report be submitted to a future meeting of the IJB. This was agreed unanimously.

DECIDED:

(a) That the mid-year update to 30 September 2016 on the 2016/17 performance, as detailed in the scorecard presented in Appendix 2 to the report, be noted;

(b) That it be noted that the indicators in the scorecard were reported at a number of frequencies, that the information may not always be available at the end of the reporting period and that the data provided in the report was the most up-to-date information available; and

(c) That an update report be submitted to a future meeting relative to progress on addressing the waiting times for paediatric Speech and Language Therapy.

Under reference to item 10 of the Minute of the meeting of this Joint Board held on 18 March 2016 the Chief Officer submitted a report relative to progress made with implementing the Participation, Engagement and Communication (PEC) Strategy which had been improved at the meeting of the IJB held on 20 November 2015.

The report intimated that a PEC Working Group had been established to take forward actions arising from the PEC strategy. The HSCP now had both a Twitter account and a Facebook page; a monthly HSCP Team Brief was cascaded from the Chief Officer throughout the HSCP; Leadership Network sessions were held on a quarterly basis; work was progressing on a logo and branding for the HSCP; work on the HSCP website had commenced; a Joint Staff Partnership Forum had been established to improve communication with the recognised staff associations; and a public event would be organised on an annual basis to disseminate information from the HSCP’s annual report.

DECIDED: That progress made to implement the PEC Strategy 2016/19 be noted.

The Chief Officer submitted a report relative to an update on the IJB’s non-financial governance arrangements for the period 1 April to 30 September 2016, specifically highlighting progress on the implementation arrangements for Freedom of Information and the Publication Scheme; health and safety; complaints; business continuity; insurance and claims; and risk management.

DECIDED: That the report and the progress made with regards to the implementation arrangements detailed therein be noted.

In terms of Standing Order 4, the Convener advised that, taking into account the uncertainties around the allocation of health resources identified in item 3 of this Minute, this item of business would be continued to a future meeting of the IJB.

DECIDED: That consideration of the Strategic Plan 2016/19 be continued to a future meeting of the IJB.

 

 

 

 

The Chief Social Work Officer (CSWO) submitted a report relative to his annual report which he had submitted to the meeting of Renfrewshire Council held on 29 September 2016. The Public Bodies (Joint Working) Scotland Act 2014 established that CSWO's would also be part of the HSCP governance structures in order to carry out those statutory duties in relation to social work services provided by those partnerships.

The Council’s Director of Children’s Services, in his role as CSWO, provided an overview of the report, referred to the role and key areas of activities of the CSWO locally and outlined the issues and challenges encountered during 2015/16, local arrangements for the discharge of functions of the post, changes to governance arrangements in light of the integration of adult health and social care and the creation of the Children’s Services Directorate within the Council together with changes in national guidance on the role of the CSWO.

DECIDED:

(a) That the key activities outlined within the report be noted;

(b) That it be noted that the report would be submitted to the Office of the Chief Social Work Officer at the Scottish Government; and

(c) That it be agreed that annual reports would continue to be provided to the IJB.

The Chief Officer submitted a report relative to proposals on how the IJB should fulfil its strategic planning responsibility for unscheduled care.

The report defined unscheduled care as the unplanned treatment or care of a patient usually as a result of an emergency or urgent event. The Scottish Government had made unscheduled care an important area of focus for the health service in Scotland and had set key targets in relation to reduced waiting times in A&E and a reduction in the number of emergency admissions to hospital.

The report outlined the IJB’s responsibilities in relation to accident and emergency services provided in hospitals as well as various inpatient services.  The Scottish Government had launched its Unscheduled Care Improvement Plan in May 2015  and NHS Greater Glasgow & Clyde had established an Unscheduled Care Programme Board under the chairmanship of the Board's Chief Executive.  The outcome of the Board's programme would be reflected in the IJB's unscheduled care plan. 

DECIDED:

(a) That the report be noted; and

(b) That the development of a Strategic Commissioning Plan for Unscheduled Care be approved for submission to a future meeting of the IJB.

The Chief Officer submitted a report relative to the development of a falls prevention and management strategy to reduce the number of falls and falls-related injuries within Renfrewshire in line with national, NHS Greater Glasgow and Clyde and Renfrewshire strategic priorities. A copy of the NHS Greater Glasgow & Clyde ‘Policy for the Prevention and Management of Falls for Adults aged 16 and over’ was attached as Appendix 1 to the report and a copy of the proposed Renfrewshire HSCP ‘Renfrewshire Falls Prevention & Management Strategy – An Integrated Approach’ was attached as Appendix 2.

The Renfrewshire Falls Prevention & Management Strategy was developed by the Renfrewshire Falls Prevention & Management Group through the support of three subgroups covering care homes; the third and independent sector; and community health and social care.  The Strategy would be circulated widely and awareness raising would take place across relevant groups and agencies throughout late 2016 and early 2017.  A systematic staff and volunteer training programme would then take place throughout 2017.

DECIDED: That the implementation of the Renfrewshire Falls Prevention and Management Strategy be approved.

DECIDED: That it be noted that the next meeting of the IJB would be held at at 9.30 am on Friday 20 January 2017 in the Abercorn Conference Centre, Renfrew Road, Paisley.