Councillor Jacqueline Cameron, Councillor Jennifer Adam-McGregor and Councillor Lisa-Marie Hughes (all Renfrewshire Council); Dr Donny Lyons, Morag Brown and Dorothy McErlean (all Greater Glasgow & Clyde Health Board); Karen Jarvis (Registered Nurse); Alex Thom (Registered Medical Practitioner (non-GP)); David Wylie (Health Board staff member involved in service provision); Helen McAleer (unpaid carer residing in Renfrewshire); Stephen Cruickshank (service user residing in Renfrewshire); Graham Capstick (Trade Union representative for Health Board); David Leese, Chief Officer and Sarah Lavers, Chief Finance Officer (both Renfrewshire Health and Social Care Partnership); and Dorothy Hawthorn (substitute for Peter Macleod, Chief Social Work Officer (Renfrewshire Council)).

Dr Donny Lyons, Chair, presided.

Ken Graham, Head of Corporate Governance (Clerk) and Elaine Currie, Senior Committee Services Officer (both Renfrewshire Council); and Iain Beattie, Head of Health and Social Care (Paisley), Caroline Burling, Acting Head of Mental Health, Addictions and Learning Disability Services, Fiona Mackay, Head of Strategic Planning & Health Improvement and Mandy Ferguson, Head of Health and Social Care (West Renfrewshire) (all Renfrewshire Health and Social Care Partnership).

The meeting adjourned at 10.40 am and reconvened at 10.45 am.

 

 

Councillor Scott Kerr (Renfrewshire Council): Dr Linda de Caestecker (Greater Glasgow and Clyde Health Board); Alan McNiven (third sector representative) and John Boylan (Trade Union representative for Council).

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

The Minute of the meeting of the Integration Joint Board (IJB) held on 26 January 2018 was submitted.  

DECIDED: That the Minute be approved.

Under reference to item 2 of the Minute of the meeting of the IJB held on 26 January 2018 the Chief Officer submitted a report providing an update on the day care services for adults with learning difficulties operated by Capability Scotland, on behalf of the Renfrewshire Health and Social Care Partnership (HSCP), in Renfrewshire at Whitehaugh and West Lane Gardens, Paisley. 

The report intimated that staff from Renfrewshire Learning Disability Service had worked with all current Capability Scotland service users and carers/families to undertake individual assessments of their current needs and allocate individual SDS budgets.  Staff continued to support service users and their carers/families to consider their options in line with SDS legislation and to meet their choice of alternative provision.

The Project Plan, which detailed the planning work underway to ensure service users and their carers/families were supported as sensitively as possible, formed Appendix 1 to the report and the process the HSCP had established to ensure it could be responsive in supporting service users and their carers/families to identify and access services which they were both happy to attend and that met their care requirements formed Appendix 2 to the report.

The HSCP held a provider event on 30 January 2018 to help service users and their carers/families to develop a greater awareness of the alternative service options available within Renfrewshire.

Capability Scotland had submitted a proposal ‘Grow’ for the reconfiguration of their adult learning disability day services provided to clients in Renfrewshire.  Based on the HSCP and Renfrewshire Council Procurement Services appraisal of this model, the Chief Officer was of the considered view that whilst largely positive in its proposed approach, in its proposed form this model did not offer anything different to similar services already available in Renfrewshire and did not represent best value in comparison.

It was noted that Renfrewshire Council, at its meeting held on 2 March 2018, decided as part of the 2018/19 adult social health budget that “In addition, it be agreed that the required draw was made in 2018/19 from the resources carried forward to support Adult Social Care as referred to in paragraph 1.10 of the Director’s report, to fund the Health and Social Care Partnership for the provision of day care services currently provided at West Lane Gardens in Johnstone and Whitehaugh in Paisley until the end of 2018/19, providing greater time to support families to meet the choices being made by clients as to their care requirements.”

 

 

Based on this Council budget commitment, and subject to IJB approval, the Chief Officer had agreed with Capability Scotland that the service could be funded to operate over the course of 2018/19.  This would provide a longer period to support service users and to make choices regarding their future care requirements.

Significant discussion took place at the meeting regarding these proposals and some members expressed concerns.

It was proposed (i) that the ongoing work to support individual service users and their carers/families in relation to their care requirements be noted; (ii) that the Chief Officer’s recommendation not to progress Capability Scotland’s alternative service model be approved; (iii) that the motion made in Renfrewshire Council’s 2018/19 Budget in relation to Capability Scotland be noted; (iv) that it be agreed that Capability Scotland would continue to operate this service using the available funding from Renfrewshire Council over the course of 2018/19; (v) that it be noted that a Carers Working Group had been established and that consideration would be given to the shape of day services beyond 2018/19; (vi) that the Chief Officer submit a report to the next meeting of the IJB relative to the timescales involved in completing individual assessments and SDS process for each service user; and (vii) that an open meeting be held to discuss future service delivery arrangements to involve service users and their carers/family members.  This was agreed.

DECIDED:

(a) That the ongoing work to support individual service users and their carers/families in relation to their care requirements be noted; 

(b) That the Chief Officer’s recommendation not to progress Capability Scotland’s alternative service model be approved;

(c) That the motion made in Renfrewshire Council’s 2018/19 Budget in relation to Capability Scotland be noted;

(d) That it be agreed that Capability Scotland would continue to operate this service using the available funding from Renfrewshire Council over the course of 2018/19; 

(e) That it be noted that a Carers Working Group had been established and that consideration would be given to the shape of day services beyond 2018/19; 

(f) That the Chief Officer submit a report to the next meeting of the IJB relative to the timescales involved in completing individual assessments and SDS process for each service user; and

(g) That an open meeting be held to discuss future service delivery arrangements to involve service users and their carers/family members and other interested parties.

The Head of Administration submitted a report relative to the re-appointment of Dr Donny Lyons and Morag Brown as voting members of the IJB, representing NHS Greater Glasgow and Clyde Health Board.

The report intimated that the IJB was formally established on 27 June 2015 and that Dr Donny Lyons and Ms Morag Brown were appointed to the IJB at the first meeting held on 18 September 2015. 

Section 2.2 of the Procedural Standing Orders for the IJB stated that ‘the term of office of Members of the IJB shall be for a period of up to three years’ and section 2.6 stated that ‘on expiry of a Member’s term of appointment the Member shall be eligible for re-appointment provided that he/she remains eligible and is not otherwise disqualified from appointment.’

The Clerk advised non-voting members that they would require to obtain authority from their respective organisations regarding re-appointment to the IJB prior to their three-year membership term ending. 

DECIDED:

(a) That the report be noted;

(b) That the re-appointment of Dr Donny Lyons and Ms Morag Brown as two of the voting members representing NHS Greater Glasgow and Clyde Health Board, per the timescales identified be approved; and

(c) That it be noted that further reports would be brought to the IJB in June and September 2018 to ratify re-appointments of both voting and non-voting members in line with the term of office for their membership category.

Under reference to item 6 of the Minute of the meeting of the IJB held on 24 November 2017 the Chief Officer submitted a report seeking support for the HSCP’s evolving Change and Improvement Programme and approval of a number of budget reinvestment proposals in line with the IJB’s financial and strategic plans.

The report intimated that the Change and Improvement Programme was being delivered through three workstreams and Appendix 1 to the report provided an overview of the supporting projects which were being delivered by each workstream and progress to date.

As part of the ongoing financial planning process, the HSCP Senior Management Team had been working with the Chief Finance Officer to mitigate a number of financial risks facing the IJB, namely, the impact of an increased cost pressure on prescribing budgets due to the impact of short supply and the rising cost of medicines; the requirement to proactively manage the funding of Mental Health Special Observations.  The IJB inherited a significant financial pressure as, prior to the HSCP being established, no budget was in place or allocated to meet these costs thereby creating an overspend in mental health budgets.  Over 2017/18 the Chief Finance Officer forecast an unfunded spend on special observations of circa £1.35 million even with management action to mitigate the costs associated with this; and Renfrewshire Council Children’s Services decision to revise its current speech and language therapy funding allocation to the HSCP by £100,000 as of 1 April 2018.  Section 5 of the report detailed the budget proposals which would support to mitigate these risks.

Significant discussion took place at the meeting regarding these proposals and some members expressed concerns.

It was proposed (i) that the content of the report be noted; (ii) that the budget proposals set out in section 5.10 of the report be not approved at this time and that consideration of the budget proposals be continued; (iii) that the Chief Officer submit a report to the IJB following further consideration of the budget proposal; (iv) that it be noted that Renfrewshire Council had revised its current speech and language therapy funding allocation to the HSCP by £100,000 as of 1 April 2018;  (v) that the HSCP look at how they engage and involve staff and Trade Unions prior to submitting reports of this nature to the IJB in future; (vi) that it be noted that a special meeting of the IJB would be held to further consider these budget proposals and that this date would be provided to all members once known; and (vii) That it be noted that regular updates would continue to be brought to the IJB to report on progress and to seek approval for any new change and improvement work, including further savings proposals, to be included within this evolving programme. This was agreed.

DECIDED:

(a) That the content of the report be noted;

(b) That the budget proposals set out in section 5.10 of the report be not approved at this time and that consideration of the budget proposals be continued; 

(c) That the Chief Officer submit a report to the IJB following further consideration of the budget proposal; 

(d) That it be noted that Renfrewshire Council had revised its current speech and language therapy funding allocation to the HSCP by £100,000 as of 1 April 2018; 

(e) That the HSCP look at how they engage and involve staff and Trade Unions prior to submitting reports of this nature to the IJB in future; 

(f) That it be noted that a special meeting of the IJB would be held to further consider these budget proposals and that this date would be provided to all members once known; and

(g) That it be noted that regular updates would continue to be brought to the IJB to report on progress and to seek approval for any new change and improvement work, including further savings proposals, to be included within this evolving programme.

The Chief Finance Officer submitted a report relative to the revenue budget positions from 1 April 2017 to 2 February 2018 for Social Work and from 1 April 2017 to 31 January 2018 for the Health Board, as detailed in appendices 1 and 2 to the report. 
 
The report provided an update on the implementation of the Living Wage for 2017/18.

The overall revenue position for the HSCP was a breakeven position as detailed in the report.  The achievement of the in-year and year-end breakeven position for Social Work Adult Services was dependent on the application of reserves carried forward from 2016/17.

The key pressures were highlighted in sections 4 and 5 of the report.  Appendices 3 and 4 to the report provided a reconciliation of the main budget adjustments applied this current financial year; Appendix 5 to the report detailed the GP prescribing position; Appendix 6 to the report detailed the Partnership hosted budget position as at 31 December 2017; and Appendix 7 to the report detailed the reserve balances as at 31 January 2018.

The report intimated that in line with the approved Reserves Policy, in order to provide future security against unexpected cost pressures and aid financial stability any net underspend within 2017/18 would be transferred to reserves at the end of the financial year.  Alternatively, general reserves might be required to mitigate against the budget pressures referred to within the report.

DECIDED: 

(a) That the current revenue budget position be noted;

(b) That the progress of the implementation of the Living Wage for 2017/18 be noted; and

(c) That the current position and application of the Partnership’s reserves be noted.

The Chief Finance Officer submitted a report relative to the financial allocation and budgets made available to the IJB for 2018/19 by Renfrewshire Council and NHSGG&C and outlining the main financial pressures on health and adult social care services.  

The Scottish Government published their draft budget for 2018/19 on 14 December 2017 which was subject to parliamentary approval over the course of January and February 2018.  A copy of the letter from the Scottish Government was appended to the report.  Included within the conditions of the 2018/19 budget was the continued prioritisation of financial support for social care including the use of funding provided through the health budget of £355 million to support adult social care services.  For Renfrewshire HSCP this amounted to £12.254 million.  The report set out the implications of the Scottish Government budget announcement and provided members with an overview of the IJB’s anticipated budget allocation for 2018/19.

It was proposed (i) that the delegated adult social care budget for 2018/19 be accepted; (ii) that formal assurance be provided 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 for the provision of delegated health services; (iii) that the assumptions in the indicative 2018/19 delegated budget as detailed in the report be noted; (vi) that as some of the recommendations in relation to the delegated health budget detailed in the Change and Improvement Programme Update, considered at item 4 of this Minute, were not approved that a special meeting of the IJB would be held to further consider these budget proposals  and the delegated health budget for 2018/19; (v) that, subject to the assumptions detailed in the report being included within the final budget offer made to the HSCP, responsibility for accepting the 2018/19 delegated health budget be delegated to the Chief Officer and Chair of the IJB; and (vi) that the use of reserves from the health budget to fund the impact of delays in the implementation of the required savings for the health delegated budget in 2018/19 be approved.  This was agreed.

DECIDED: 

(a) That the delegated adult social care budget for 2018/19 be accepted;

(b) That formal assurance be provided 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 for the provision of delegated health services;

(c) That the assumptions in the indicative 2018/19 delegated budget as detailed in the report be noted;

(d) That as some of the recommendations in relation to the delegated health budget detailed in the Change and Improvement Programme Update, considered at item 4 of this Minute, were not approved that a special meeting of the IJB would be held to further consider these budget proposals and the delegated health budget for 2018/19;

(e) That, subject to the assumptions detailed in the report being included within the final budget offer made to the HSCP, responsibility for accepting the 2018/19 delegated health budget be delegated to the Chief Officer and Chair of the IJB; and

(f) That the use of reserves from the health budget to fund the impact of delays in the implementation of the required savings for the health delegated budget in 2018/19 be approved.

The Chief Officer submitted a performance management focus report on the HSCP’s organisational health which provided an overview of performance in sickness absence; the Knowledge and Skills Framework; induction; inspection and iMatter staff surveys; Nursing and Midwifery Council registration; HSCP workforce and communications.

DECIDED: That Renfrewshire HSCP’s performance management focus report on organisational health 2017/18 be approved.

Under reference to item 7 of the Minute of the meeting of the IJB held on 26 January 2018 the Chief Officer submitted an update report relative to preparation for implementation of The Carers (Scotland) Act which would come into force on 1 April 2018.

 

 

The report provided information on the recent approval of an updated Renfrewshire Integration Scheme which reflected the provisions in the Carers Act to be delegated to the IJB; an overview of the new adult carer eligibility criteria and case studies to illustrate the different support available for carers who fell outwith the critical or substantial threshold; arrangements in place for Adult Carer Support Plans and Young Carer Statements; the timeline and arrangements for the future development of a Carers Strategy for Renfrewshire; work underway to raise awareness for the future development of a Carers Strategy for Renfrewshire; work underway to raise awareness of the Act among HSCP staff and offer training where appropriate; the key role the Carers Centre was playing on behalf of the HSCP in raising public awareness of the Carers Act and the provision of a carers information service for Renfrewshire; and management of the key risks identified by the Carers Act Strategic Steering Group.

The updated Carers Act Implementation Plan formed Appendix 1 to the report; Renfrewshire’s Adult Carer Eligibility Criteria formed Appendix 2 to the report and indicated where the local authority had a duty to support and where it had a power to support and Appendix 3 to the report detailed case studies setting out the type of support carers could access relative to where they were scored in terms of the eligibility criteria.

DECIDED:

(a) That the significant preparatory work underway across Renfrewshire to achieve ‘readiness’ in time for commencement of the Carers Act in April 2018 be noted;

(b) That the timeline and arrangements for future development of a Carers Strategy for Renfrewshire be noted; and

(c) That a further report be submitted to the IJB when all national guidance had been made available.

The Chief Officer submitted a report relative to the HSCP Equality Outcomes and Mainstreaming Progress Report 2018, a copy of which was appended to the report.

The report intimated that the Scottish Government added IJBs to the Equality Act 2010 (Specific Duties) (Scotland) Amendment Regulations 2015 which placed a duty on the IJB to consult on how the policies and decisions affected the people who were protected under the Equality Act.  This amendment required the IJB to publish outcomes and a report on progress made to mainstream the equality duty by 20 April 2016 and report on progress every two years thereafter.  

DECIDED:

(a) That the progress documented within the Equality Outcomes and Mainstreaming Progress Report 2018 be noted; and

(b) That the publication of the Equality Outcomes and Mainstreaming Progress Report 2018 be approved.

The Clerk submitted a report relative to proposed dates of meetings of the IJB in 2018/19.

DECIDED: 

(a) That it be noted that the next meeting of the IJB would be held at 10.00 am on 29 June 2018 in the Abercorn Conference Centre;

(b) That meetings of the IJB be held at 10.00 am on 14 September and 23 November 2018 and 25 January, 22 March and 28 June 2019; and

(b) That meetings of the IJB be held in the Abercorn Conference Centre, Renfrew Road, Paisley unless that venue is unavailable or unsuitable, in which case it be delegated to the Clerk and Chief Officer, in consultation with the Chair and Vice Chair, to determine an alternative venue.