Councillor Jacqueline Cameron, Councillor Jennifer Adam-McGregor, Councillor Lisa-Marie Hughes and Councillor Scott Kerr (all Renfrewshire Council); Dr Donny Lyons, Morag Brown, Dorothy McErlean and Dr Linda de Caestecker (all Greater Glasgow & Clyde Health Board); Karen Jarvis (Registered Nurse); Louise McKenzie (Council staff member involved in service provision); Alan McNiven (third sector representative); John Boylan (Trade Union representative for Council); 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 John Trainer, Chief Social Work Officer (Renfrewshire Council).

Dr Donny Lyons, Chair, presided.

Lynn Mitchell, Managing Solicitor (Contracts and Conveyancing) (on behalf of Clerk), and Elaine Currie, Senior Committee Services Officer (both Renfrewshire Council); Jackie Dougall, Head of Health and Social Care (West Renfrewshire), Christine Laverty, Head of Mental Health, Addictions and Learning Disability Services, Fiona Mackay, Head of Strategic Planning & Health Improvement, Peter McCulloch, Interim Head of Health and Social Care (Paisley) and Jean Still, Head of Administration (all Renfrewshire Health and Social Care Partnership).

John Trainer entered the meeting during consideration of the following item of business.

DECIDED: That it be agreed that the next meeting of the IJB would be held at 9.30 am on 22 March 2019 in the Abercorn Conference Centre, Renfrew Road, Paisley.

Alex Thom (Registered Medical Practitioner (non-GP); David Wylie (Health Board staff member involved in service provision); Fiona Milne (unpaid carer residing in Renfrewshire); Stephen Cruickshank (service user residing in Renfrewshire); and Dr Stuart Sutton (Registered Medical Practitioner (GP).

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

The Minute of the meeting of the Integration Joint Board (IJB) held on 23 November 2018 was submitted.  

DECIDED: That the Minute be approved.

Under reference to item 1 of the Minute of the meeting of this IJB held on 29 June 2018, the Chief Officer submitted a report providing an update on the day care services for adults with learning disabilities operated by Capability Scotland, on behalf of the Renfrewshire Health and Social Care Partnership (HSCP), in Renfrewshire at Whitehaugh, Paisley and West Lane Gardens, Johnstone. 

The report intimated that all service users had been assessed and allocated individual SDS budgets; almost half of these service users had moved or were in transition to a positive destination in terms of future service provision; through the HSCP’s work with service users and families, a number of people expressed their interest in the Community Networks Service but only if it was made available in the Johnstone area; and there were a small number of individuals who had not yet identified alternative service provision and the HSCP would continue to engage with these individuals to explore available options.

It was noted that the Community Networks Service currently operated in the Paisley area and in response to requests for this service to be available in the Johnstone area, the Community Networks Service would be extended. The HSCP were currently working with Renfrewshire Council to scope out the property options available for a Community Networks Hub in Johnstone and the building at West Lane Gardens was being considered alongside other properties in the Johnstone area.  A range of options were being explored in relation to staffing of the future service and the HSCP was working closely with Capability Scotland.

The HSCP would continue to work with service users to support their transition to the range of alternative service provision available including the newly extended Community Networks Service in Johnstone and would work with key stakeholders to take forward the Community Networks Service extension.

DECIDED: 

(a) That it be noted that Capability Scotland had continued to operate this service using the extended funding made available from Renfrewshire Council and that the service would cease to operate from April 2019; 

(b) That it be noted that a number of service users had been supported to move on to alternative service provision; 

 

(c) That the ongoing work supporting the remaining service users and their families/carers in relation to future care requirements be noted; and

(d) That the extension to the existing Community Networks Service in Johnstone be noted.

The Chief Finance Officer submitted a report relative to the revenue budget position at 30 November 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 an underspend as detailed in the report, prior to the transfer of balances to General Reserves at the financial year-end.   

The key pressures were highlighted in section 4 of the report.  Appendix 3 to the report detailed the adult social care budget projected year-end position as at 31 March 2019; Appendix 4 to the report detailed the health revenue budget position as at 30 November 2018; Appendix 5 to the report detailed the health revenue budget position as at 31 March 2019; Appendix 6 to the report detailed the 2018/19 adult social care financial allocation to the HSCP; Appendix 7 to the report detailed the 2018/19 health financial allocation to the HSCP and Appendix 8 to the report detailed the projected movement in reserves.

The report provided information on the set-aside budget; reserves; financial planning 2019/20 and the Living Wage increase for 2018/19.

A copy of the letter dated 12 December 2018 from the Director of Health Finance, Corporate Governance and Value, Scottish Government, to all NHS Chairs, NHS Directors of Finance and Integration Authority Chief Officers, providing details of the funding settlement for Health Boards, which included IJBs, formed Appendix 9 to the report.  It was noted that included within the funding settlement for Health and Social Care Integration was an allocation of additional funding to IJBs.  The letter specifically stated that in 2019/20 NHS payments to Integration Authorities for delegated health functions must deliver a real-terms uplift in baseline funding, before provision of funding for pay awards, over 2018/19 cash levels; and in addition to this, and separate from the Board funding uplift, would be two elements of funding for Social Care: £120 million would be transferred from the Health Portfolio to local authorities in-year for investment in integration, including delivery of the Living Wage and uprating free personal care, and school counselling services; and £40 million had been included directly in the Local Government settlement to support the continued implementation of the Carers (Scotland) Act 2016 and extending free personal care to under 65s, as set out in the Programme for Government.

This funding was to be additional to each council’s 2018/19 recurrent spending on social care and was not substitutional, which meant that, when taken together, local authorities social care budgets for allocation to Integration Authorities, plus those retained for non-delegated social care functions, and funding for school counselling services must be £160 million greater than 2018/19 recurring budgets.

A copy of the letter dated 12 December 2018 from the Cabinet Secretary for Finance, Economy and Fair Work, Scottish Government, to Leaders of Scottish local authorities, setting out the Scottish Government’s draft spending and tax plans for 2019/20 formed Appendix 10 to the report. Within this letter, the Cabinet Secretary confirmed that, in return for their 2019/20 settlement, local authorities would be expected to deliver certain specific commitments, including the commitment that the allocation to Integration Authorities must be £160 million greater than 2018/19 recurrent budgets. The allocation of this additional funding to the IJB would form part of the overall adult social care resource assessment currently being discussed with, and subject to agreement with, Renfrewshire Council as part of their 2019/20 budget setting process.

DECIDED: 

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

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

(c) That the current position as regards the 2019/20 draft Scottish Budget be noted.

The Chief Officer submitted a report relative to the benchmarking report for the HSCP for 2018/19.

The report intimated that the HSCP’s performance had been measured against the HSCPs within the Greater Glasgow and Clyde area, being East Dunbartonshire, East Renfrewshire, Glasgow City, Inverclyde and West Dunbartonshire and also within the ‘Family Group’, as determined by Health Improvement Scotland, consisting of Stirling, Clackmannanshire, Dumfries and Galloway, Falkirk, Fife, South Ayrshire, South Lanarkshire and West Lothian Councils.

Appendix 1 to the report detailed the National Core Suite of Integration Indicators Benchmarking Exercise with the HSCP Family Group as at December 2018; Appendix 2 to the report detailed the National Core Suite of Integration Indicators Benchmarking Exercise with Greater Glasgow and Clyde HSCPs as at December 2018; Appendix 3 to the report detailed the Health and Wellbeing Profile Indicators Benchmarking Exercise with the HSCP Family Group as at December 2018 and Appendix 4 to the report detailed the Health and Wellbeing Profile Indicators Benchmarking Exercise with NHS Greater Glasgow and Clyde HSCPs as at December 2018. 

The appendices to the report presented a range of indicators providing an overview of health and its wider determinants at a local level.  The results highlighted in pink were the same as the Scottish average; those highlighted in green were better than the Scottish average; those highlighted in orange were less than the Scottish average and those highlighted in blue detailed the best group result.

DECIDED: That the Benchmarking Report 2018/19 for Renfrewshire HSCP be noted.

The Chief Officer submitted a report relative to the Adult Health and Wellbeing Survey 2017/18 Renfrewshire Summary Report, a copy of which was appended to the report.

The report intimated that the 2017/18 survey provided an update for the Renfrewshire area on progress towards performance assessment targets and national health behaviour targets against 2008 baseline data. The survey was formed around a set of core questions to allow monitoring of trends over time where possible. The information helped build a picture of the public’s health in Renfrewshire and the results could be compared to the Greater Glasgow and Clyde average.

The objectives of the survey were to examine trends in key indicators since 2008; monitor and compare changes amongst those living in the most deprived areas with other areas; and provide health and wellbeing information at HSCP level and determine change over time.  

The survey results would be presented to the Strategic Planning Group and would inform the Strategic Plan for 2019/22.

DECIDED: That the Adult Health and Wellbeing Survey 2017/18 for Renfrewshire and its implications for the Strategic Plan 2019/22 be noted.

The Chief Officer submitted a report providing an update on the non-financial governance arrangements in place from 1 April 2017.

The report provided performance information regarding Freedom of Information; health and safety; complaints; civil contingencies and business continuity; insurance and claims; risk management; and general data protection regulations.

Concern was expressed around violence and aggression and the high number of physical assaults on staff.

It was proposed (a) that the content of the report be noted; and (b) that more detailed information be included in future reports in relation to violence and aggression to allow these incidents to be seen in context.  This was agreed

DECIDED: 

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

(b) That more detailed information be included in future reports in relation to violence and aggression to allow these incidents to be seen in context.

Under reference to item 5 of the Minute of the meeting of the IJB held on 23 November 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. 

 

Concerns were raised regarding the perceived lack of detail issued to carers in relation to the Learning Disabilities service review; how carers felt that the final report on this service review would be a complete surprise to those involved; that the process had not been transparent; and that members of the IJB had not seen any actual outcomes from this service review, they had only been made aware of emerging themes at development sessions.

Members were advised that the Learning Disabilities Planning Group had been sighted on the themes arising from this service review; that it had been a very transparent process to date; that the early findings from the service review had been shared with the Carers Centre in December 2018; and that the independent report on this service review would contain recommendations which would be looked at by the HSCP and the findings reported to the IJB.   

The Carers Short Breaks Statement, which formed the appendix to the report, set out the HSCP’s policy on providing short breaks to carers as well as information on how carers could access a short break.  Renfrewshire HSCP had adopted the Shared Care Scotland description of what constituted a short break.

It was proposed (a) that the content of the report be noted; (b) that the Carers Short Break Services Statement, as detailed in the appendix to the report, be approved; (c) that it be agreed that the Carers Short Break Services Statement be reviewed on 1 April 2020 and annually thereafter; and (d) that detailed reports on the current service reviews would be submitted to the next meeting of the IJB to be held on 22 March 2019.  This was agreed unanimously.

DECIDED: 

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

(b) That the Carers Short Break Services Statement, as detailed in the appendix to the report, be approved; 

(c) That it be agreed that the Carers Short Break Services Statement be reviewed on 1 April 2020 and annually thereafter; and

(d) That detailed reports on the current service reviews be submitted to the next meeting of the IJB to be held on 22 March 2019.

The Chief Officer submitted a report relative to the 10-year NHSGGC Public Health Strategy and Renfrewshire HSCP’s early actions in response.

Dr Linda de Caestecker gave a presentation which included information on the aim of the strategy; female life expectancy trends within Glasgow and Clyde Valley; child poverty; pressures on health services 2015/16 to 2017/18; becoming a public health organisation; Scotland’s public health priorities; programmes in the strategy; health being included in all policies; key principles of implementation; the ladder of community participation; and the next steps to be taken.

The report intimated that the NHSGGC Public Health Strategy: Turning the tide through prevention was published in August 2018 and was led by the Director of Public Health. The strategy set out the strategic direction for public health across the Health Board area with a specific focus on prevention; reflected the national ambition of whole system working, creating an impetus for change; was expected to inform Community Plans and HSCP Strategic Plans; set out a clear focus on prevention of ill-health and on the improvement of wellbeing in order to increase the healthy life expectancy of the whole population and reduce health inequalities.

The report provided detail on the strategic objectives of the strategy and the HSCP response to the strategy in terms of priorities for health and wellbeing in the three-year Strategic Plan.  

DECIDED: That the strategic direction for public health over the next 10 years be noted.

The Chief Officer submitted a report relative to the Renfrewshire Alcohol and Drug Partnership (ADP) Annual Report 2017/18, a copy of which formed the appendix to the report.

The report intimated that the ADP had key responsibility for implementing the National Policy Framework and driving forward local action to reduce the impact of alcohol and drugs.  ADPs in Scotland produced annual reports for submission to the Scottish Government and to ensure consistency, the Scottish Government had developed a standard template designed to allow consistent reporting on how ADPs were meeting national and local priorities.

The ADP Annual Report set out the financial framework used to deliver local and national outcomes ranging from prevention and early intervention initiatives to treatment and support services which were recovery and outcome-focused.  It also reflected on progress achieved against Ministerial priorities, outlining improvement goals.

DECIDED: That the contents of the report be noted.

The Chief Officer submitted a report relative to the Integration Joint Board (IJB) Records Management Plan, a copy of which was appended to the report.

The report intimated that the IJB was obliged to submit and maintain a Records Management Plan as defined in and in accordance with Part 1 of the Public Records (Scotland) Act 2011. The Records Management Plan required to be submitted to the Keeper of the Records of Scotland by 1 February 2019.

Both Renfrewshire Council and NHS Greater Glasgow and Clyde had agreed Record Management Plans in place.  The IJB Records Management Plan set out the arrangements for the management of the IJB’s records and the relationship with Renfrewshire Council’s and NHS Greater Glasgow and Clyde’s Records Management Plans.  The IJB did not hold any personal information and the Records Management Plan related to the IJB’s committees, plans and policies.

DECIDED: That the content of the Records Management Plan be approved and reviewed as required and submitted to the Keeper of the Records of Scotland by 1 February 2019.