Councillor Jacqueline Cameron, Councillor Jennifer Adam-McGregor, Councillor Lisa-Marie Hughes and Councillor Scott Kerr (all Renfrewshire Council); Dr Donny Lyons, Morag Brown and Dr Linda de Caestecker (all Greater Glasgow & Clyde Health Board); Karen Jarvis (Registered Nurse); Sinead McAree (proxy for Alex Thom (Registered Medical Practitioner (non-GP)); Louise McKenzie (Council staff member involved in service provision); David Wylie (Health Board staff member involved in service provision); Fiona Milne (unpaid carer residing in Renfrewshire); Stephen Cruickshank (service user residing in Renfrewshire); Graham Capstick (Trade Union representative for Health Board); Dr Chris Johnstone (proxy for Dr Stuart Sutton (Registered Medical Practitioner (GP)); David Leese, Chief Officer and Sarah Lavers, Chief Finance Officer (both Renfrewshire Health and Social Care Partnership); and Peter Macleod, Chief Social Work Officer (Renfrewshire Council).

Dr Donny Lyons, Chair, presided.

Ken Graham, Head of Corporate Governance (Clerk), John Trainer, Head of Childcare and Criminal Justice and Elaine Currie, Senior Committee Services Officer (all Renfrewshire Council); Jackie Dougall, Head of Health and Social Care (West Renfrewshire) and Jean Still, Head of Administration (both Renfrewshire Health and Social Care Partnership); and David McConnell, Assistant Director (Audit Scotland) (for items 1 and 2 only).

Dr Lyons declared a non-financial interest in item 7 on the agenda as he was a member of the Mental Health Tribunal for Scotland. He intimated that it was his intention to remain in the meeting and take part in any discussion.

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 item 4 of the agenda after item 1 of the agenda.


Prior to the start of the meeting the Chair welcomed Fiona Milne and Louise McKenzie to their first meeting of the Integration Joint Board.  The Chair welcomed Peter Macleod to the meeting following illness.

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

Dorothy McErlean (Greater Glasgow & Clyde Health Board); Alex Thom (Registered Medical Practitioner (non-GP); Alan McNiven (third sector representative) and Dr Stuart Sutton (Registered Medical Practitioner (GP).

The Minute of the meeting of the Integration Joint Board (IJB) held on 14 September 2018 was submitted.  

With reference to item 6 of the Minute, it was proposed that the Minute be amended by the addition of the following sentence ‘The engagement of carers was discussed.’  This was agreed.    

DECIDED: That the Minute, as amended, be approved.

Under reference to item 4 of the Minute of the meeting of this IJB held on 29 June 2018 the Clerk submitted a report providing an update on membership of the IJB.

The report intimated that at the meeting of the IJB held on 29 June 2018 consideration had been given to the expiry of the period of membership for a number of IJB members.  It had been agreed that those members whose appointments were due to expire later in 2018 be encouraged to ask the groups they represented to seek expressions of interest for future representatives of those groups on the IJB.
 
The report provided an update on the membership of the IJB following the conclusion of this process, as detailed in the schedule to the report, and sought approval for those appointments where this was required in terms of legislation.

DECIDED: 

(a) That the IJB approve the appointment or re-appointment of those non-voting members listed under category three in the schedule attached to the report; and

(b) That otherwise the membership of the IJB in the other membership categories and the expiry dates for those memberships be noted.

The Chief Finance Officer submitted a report relative to the revenue budget position at 30 September 2018 and the projected year-end position for the year ended 31 March 2019, as detailed in appendices 1 and 2 to the report. 
 
The overall revenue position for the HSCP for the year-to-date and projected outturn for 2018/19 was a breakeven position as detailed in the report.  

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 2018/19 adult social care financial allocation to the HSCP; and Appendix 6 to the report detailed the projected movement in reserves.

The report provided information on financial planning 2019/20 and beyond; the delegated adult social care budget settlement 2019/20 and the Living Wage increase for 2018/19.

It was proposed (a) that the current in-year position as at 30 September 2018 be noted; (b) that the projected year-end position for 2018/19 be noted; (c) that the proposal that the Chief Officer raise the issue of the impact of NHSGG&C revised procedures around recruitment and backfilling of vacancies in order to seek an early resolution that retained the good financial and operational controls already in place to ensure operational stability be approved; (d) that the Scottish Government’s medium-term health and social care financial framework and the potential implications for the IJB be noted; (e) that it be noted that the IJB at its meeting held on 26 January 2018 had agreed that as part of its consideration of the services provided by Capability Scotland ‘(i) that officers be encouraged to do all they can as part of the transitional period to ensure no diminution of service to service users’ and that this Minute be re-issued to members of the IJB; and (f) that a presentation be made to the next meeting of the IJB to be held on 25 January 2019 on the GGC Public Health Strategy which will include a focus on improvement and prevention measures aimed at achieving the target 1% reduction in demand for a number of health improvement initiatives.  This was agreed.

 

Reference was made to the recent e-learning course developed by NHS Education for Scotland.  It was proposed that information on this resource be issued to members and that a future development session be held for members relative to autism services.  This was agreed.

DECIDED: 

(a) That the current in-year position as at 30 September 2018 be noted;

(b) That the projected year-end position for 2018/19 be noted;

(c) That the proposal that the Chief Officer raise the issue of the impact of NHSGG&C revised procedures around recruitment and backfilling of vacancies in order to seek an early resolution that retained the good financial and operational controls already in place to ensure operational stability be approved; 

(d) That the Scottish Government’s medium-term health and social care financial framework and the potential implications for the IJB be noted;

(e) That it be noted that the IJB at its meeting held on 26 January 2018 had agreed that as part of its consideration of the services provided by Capability Scotland ‘(i) that officers be encouraged to do all they can as part of the transitional period to ensure no diminution of service to service users’ and that this Minute be re-issued to members of the IJB; 

 

(f) That a presentation be made to the next meeting of the IJB to be held on 25 January 2019 on the GGC Public Health Strategy which will include a focus on improvement and prevention measures aimed at achieving the target 1% reduction in demand for a number of health improvement initiatives; and

 

(g) That information on the recent e-learning course developed by NHS Education for Scotland be issued to members and that a future development session be held for members relative to autism services.  

The Chief Finance Officer submitted a report relative to the proposed revision to the IJB’s Reserves Policy.  

The report intimated that the current IJB Reserves Policy had been agreed at the meeting of the IJB held on 24 November 2017.  Audit Scotland, in their Renfrewshire Integration Joint Board Annual Audit Report 2017/18, had recommended that the IJB consider updating its Reserves Policy to set out a minimum as well as a maximum reserves level.  

Section 6.2 of the IJB Reserves Policy had been updated to reflect this recommendation and a copy of the revised IJB Reserves Policy formed the appendix to the report.

It was proposed that the recommendation from Audit Scotland be not implemented at this time; that the recommendation from Audit Scotland be noted and kept under consideration and revisited in six months; and that the Chair raise this matter with integration colleagues in the Scottish Government to enable them to offer a view and guidance on this matter.  This was agreed.

DECIDED: 

(a) That the recommendation from Audit Scotland be not implemented at this time; 

(b) That the recommendation from Audit Scotland be noted and kept under consideration and revisited in six months; and

 

(c) That the Chair raise this matter with integration colleagues in the Scottish Government to enable them to offer a view and guidance on this matter.

Under reference to item 6 of the Minute of the meeting of the IJB held on 14 September 2018 the Chief Officer submitted a report providing an update on the HSCP’s evolving Change and Improvement Programme including the service reviews underway.

The report intimated that the Change and Improvement Programme was being delivered through three workstreams, 1. optimising joint and integrated working and shifting the balance of care; 2. statutory requirements, national policy and compliance; and 3. service reviews to support the delivery of our market facilitation statement and strategic and financial plans. 

Some members expressed concern regarding the number of external consultants appointed to lead the service reviews; whether in the future, the HSCP would be in a position to respond to situations in-house; and around the matter of rolling-out ‘hospital at home type services’ currently underway in Lothian and Edinburgh.  The Chief Officer advised that the HSCP was currently looking at a number of options.

DECIDED: That the content of the report be noted.

The Chief Officer submitted a report relative to the Performance Management Mid-year Report 2018/19 covering the period April to September 2018.

The performance dashboard which summarised progress formed Appendix 1 to the report and the full scorecard which updated all performance measures formed Appendix 2 to the report.

There were 64 performance indicators of which 40 had targets set against them.  Performance status was assessed as either red, more than 10% variance from target; amber, within 10% variance of target; or green, on or above target.  The dashboard indicated that currently 24 performance measures were data only, 7 had red status, 12 had amber status and 21 had green status.

DECIDED: That the Performance Management Mid-year Report 2018/19 for Renfrewshire HSCP be approved.

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 27 September 2018.  The Public Bodies (Joint Working) Scotland Act 2014 established the CSWO as part of the HSCP governance structure in order to carry out those statutory duties in relation to social work services provided by those partnerships.  

The annual reports of all CSWOs were submitted to the Office of the Chief Social Work Advisor at the Scottish Government in order that a national overview report could be produced.

The report provided a summary of activity relating to the role of the Chief Social Work Officer during 2017/18.

DECIDED:
 
(a) That the key activities outlined in the report be noted; 
  
(b) That it be noted that the annual report would be submitted to the Office of the Chief Social Work Advisor 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 the climate change report submitted to the Scottish Government in line with recent legislation on compliance of the climate change duties.

The report intimated that the Climate Change (Scotland) Act 2009 and the subsequent Climate Change (Duties of Public Bodies: Reporting Requirements) (Scotland) Order 2015 required significant public bodies, of which the IJB was one, to prepare a report on their compliance with climate change duties.  IJBs were required to submit the report to the Scottish Government on or before 30 November 2018.

The report was a standard template and as a consequence related to the policies, procedures and services of the local authority and NHS Board rather than the IJB, and a copy of the climate change report was appended to the report.  

DECIDED: That the content of the report be approved.

The Chief Officer submitted a report relative to the Renfrewshire HSCP Winter Plan 2018/19. 

The report intimated that Health Boards and IJBs had received guidance from the Scottish Government to support planning and preparation for winter 2018/19. Health Boards required to be satisfied that potential disruption to NHS services, patients and carers was minimised. HSCPs in NHSGG&C had produced Winter Plans to support the NHSGG&C Board Winter Plan. The Winter Plan for Renfrewshire had been produced by the HSCP in collaboration with acute services and Renfrewshire Council. The final draft of the Winter Plan formed the appendix to the report. 

Discussion took place concerning the key action ‘Discharges at weekends and bank holidays’ and the wording used in the response column in connection with nursing homes.  It was proposed that the Chief Officer break this information down into three points of (i) numbers restricted by registration; (ii) the ‘rate and pace’ of admissions; and (iii) information around what to consider when choosing a nursing home and that the amended Renfrewshire HSCP Winter Assurance Framework be issued to members of the IJB. This was agreed.

DECIDED:

(a) That in relation to the key action ‘Discharges at weekends and bank holidays’ and the wording used in the response column in connection with nursing homes, the Chief Officer break this information down into three points of (i) numbers restricted by registration; (ii) the ‘rate and pace’ of admissions; and (iii) information around what to consider when choosing a nursing home and that the amended Renfrewshire HSCP Winter Plan be issued to members of the IJB; 

(b) That the IJB approve Renfrewshire HSCP’s draft Winter Plan 2018/19, as amended; and

(c) That the collaborative work carried out with NHSGG&C and the Winter Plan approved by the Board on 16 October 2018 be noted.

DECIDED: That it be noted that the next meeting of the IJB would be held at 10.00 am on 25 January 2019 in the Abercorn Conference Centre, Renfrew Road, Paisley.