Councillor Jacqueline Cameron, Councillor Jennifer Adam-McGregor, Councillor Lisa-Marie Hughes and Councillor James McLaren (all Renfrewshire Council); Dr Donny Lyons, 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); David Wylie (Health Board staff member involved in service provision); Fiona Milne (unpaid carer residing in Renfrewshire); Stephen Cruickshank (service user residing in Renfrewshire); John Boylan  (Trade Union representative for Council); Graham Capstick (Trade Union representative for Health Board); Dr Chris Johnstone (proxy for Dr Stuart Sutton); and David Leese, Chief Officer and Sarah Lavers, Chief Finance Officer (both Renfrewshire Health and Social Care Partnership).

Dr Donny Lyons, Chair, presided.

Ken Graham, Head of Corporate Governance (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, Carron O’Bryne, Head of Health and Social Care (Paisley), Jean Still, Head of Administration and Clare Walker, Planning and Performance Manager (all Renfrewshire Health and Social Care Partnership).

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 13 of the agenda after item 2 of the agenda.


Prior to the start of the meeting the Chair welcomed Councillor James MacLaren to his first meeting of the Integration Joint Board and invited members and officers to introduce themselves.

Under reference to item 2 of the Minute of the meeting of the IJB held on 22 March 2019, the Head of Administration submitted a report providing an update on the membership of the IJB.

The report intimated that NHS Greater Glasgow & Clyde Health Board had confirmed that Margaret Kerr had been appointed as a Non-executive Director of the Health Board and would replace Morag Brown as one of the voting members on the IJB effective from 1 April 2019.

The report further intimated that at a meeting on 9 May 2019, Renfrewshire Council had decided that Councillor James MacLaren replace Councillor Scott Kerr as one of the voting members on the IJB effective from that date. 

It was noted that in terms of the Procedural Standing Orders, and in accordance with the Integration Scheme, the position of Chair of the IJB shall rotate every two years between representatives from the NHS Board and the Council, with the Chair being from one body and the Vice-chair from the other.  In accordance with this, Councillor Cameron would be appointed as the Chair of the IJB from 15 September 2019 for a period of two years and Dr Donny Lyons would be appointed as the Vice-chair of the IJB from 15 September 2019.

Members were invited to nominate representatives from both constituent authorities to replace the positions previously held by Morag Brown and Councillor Scott Kerr as voting members of the IJB Audit Committee.  It was proposed that Margaret Kerr and Councillor Jennifer Adam-McGregor be appointed as voting members of the IJB Audit Committee and this was agreed.

It was also noted that the Chair of the IJB Audit Committee shall not be the Chair of the IJB or be representative of the same constituent authority as the Chair of the IJB and as such the voting members of NHS Greater Glasgow & Clyde Health Board consider arrangements for the Chair of the IJB Audit Committee and the voting members of Renfrewshire Council consider the arrangements for the Vice-chair of the IJB Audit Committee.

DECIDED: 

(a) That it be noted that Margaret Kerr had been appointed as a voting member of the IJB, replacing Morag Brown;

(b) That it be noted that Councillor James MacLaren had been appointed as a voting member of the IJB, replacing Councillor Scott Kerr;

(c) That it be noted that Councillor Jacqueline Cameron would be appointed as the Chair of the IJB from 15 September 2019;

(d) That it be noted that Dr Donny Lyons would be appointed as the Vice-chair of the IJB from 15 September 2019;

(e) That Margaret Kerr and Councillor Jennifer Adam-McGregor be appointed as voting members of the IJB Audit Committee, replacing Morag Brown and Councillor Scott Kerr; and

(f) That voting members consider the arrangements for the Chair and Vice-chair of the IJB Audit Committee from September 2019 and advise the Head of Administration accordingly.

The Chief Officer submitted a report relative to the Quality, Care and Professional Governance Annual Report 2018/19, a copy of which formed Appendix 1 to the report.

The report intimated that the annual report provided a variety of evidence to demonstrate continued delivery of the care components within the HSCP Quality, Care and Professional Governance Framework and the Clinical and Care Governance principles specified by the Scottish Government.

Over the last year the HSCP had continued to review its governance arrangements to ensure that the HSCP structures going forward were both efficient and effective and to avoid areas of duplication and overlap.

The Chief Officer undertook to issue information to all Renfrewshire Councillors, MPs and MSPs in relation to the complaints process.

DECIDED: 

(a) That the Quality, Care and Professional Governance Annual Report 2018/19, as detailed in Appendix 1 to the report, be noted; 

(b) That it be noted that future annual reports would be produced in line with NHS Greater Glasgow & Clyde’s reporting cycle of April to March; and

(c) That information be issued to all Renfrewshire Councillors, MPs and MSPs in relation to the complaints process.

The Chair intimated that once the items on the agenda had been considered he wished to provide an update on his activities as Chair.

The Chair advised of the visits to the Sunshine Recovery Café, Mirren Day Services, the Care at Home team, the Health Visiting team and the District Nursing team.

DECIDED: That the Chair’s update be noted.

The Chief Officer intimated that this would be last meeting that Dr Donny Lyons would chair, he would remain on the IJB as a voting member.  Members and officers thanked Donny for his input to the work of the Board as Chair for the past two years and for his ‘fairness’ as Chair.  

Donny thanked members and officers for the constructive meetings and the respect given to everyone.

Margaret Kerr (Greater Glasgow & Clyde Health Board); (Dr Stuart Sutton (Registered Medical Practitioner (GP)) and Alan McNiven (third sector representative).

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 22 March 2019 was submitted.  

In relation to item 4 of the Minute - 2019/20 Delegated Health and Social Care Budget - it was agreed that the Minute be amended to include a decision (g) That, in relation to the adult social care allocations to Integration Authorities, it be agreed that if Renfrewshire Council did not utilise the ringfenced 2.2% this financial year it would be carried forward to the next financial year.

In relation to item 6 of the Minute – Review of Learning Disability Day and Respite Services – it was agreed that the Minute be amended to include an additional paragraph ‘That the issues and concerns expressed by adult carers concerning the services available for people with autistic spectrum disorder be noted’ and that a further decision be added, (d) That the issues and concerns expressed by adult carers concerning the services available for people with autistic spectrum disorder be noted.

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

The rolling action log for the IJB was submitted.

DECIDED: That the rolling action log be noted.

The Chief Finance Officer submitted a report relative to the revenue budget year-end outturn for the HSCP for the 2018/19 financial year, as detailed in appendices 1 to 4 to the report. 

Budget monitoring throughout 2018/19 had shown the IJB projecting a breakeven position subject to the drawdown of reserves to fund any delays in the delivery of approved savings and the transfer of specific ring-fenced monies, including Scottish Government funding for Primary Care Improvement, Mental Health Action 15 and ADP monies, and agreed commitments to earmarked reserves.  The IJB final outturn position for 2018/19 was an underspend of £1.293 million prior to the drawdown of balances to earmarked and general reserves. The IJB approved the drawdown of reserves throughout 2018/19 in order to deliver on specific commitments including funding to mitigate any delays in delivery of approved savings and Care at Home redesign costs.  The total amount drawndown in 2018/19 was £1.305 million from earmarked reserves and £0.824 million from flexible use of non-recurring resources made available by Renfrewshire Council. 

The key pressures were highlighted in section 4 of the report; appendices 5 and 6 to the report provided a reconciliation of the main budget adjustments applied this current financial year; Appendix 7 to the report detailed the HSCP hosted budget position as at 31 March 2019 and Appendix 8 detailed the movement in reserves.

Consistent with the IJB’s Reserves Policy the report sought approval of earmarked reserves for drawdown as required, totalling £3.336 million.  Details of the earmarked reserves were detailed in section 11 and Appendix 8 of the report.

The report provided a summary of the Living Wage 2018/19; a summary of the Scottish Living Wage 2019/20 and the National Care Home Contract 2018/19.

DECIDED: 

(a) That the year-end financial position be noted; and

(b) That the proposed transfers to earmarked and general reserves, as detailed in section 11 and Appendix 8 of the report, be approved.

The Chief Finance Officer submitted a report relative to the unaudited annual accounts 2018/19 for the IJB which would be submitted for audit by the statutory deadline of 30 June 2019.  A copy of the unaudited annual accounts 2018/19 formed the appendix to the report.

The report intimated that the accounts fully complied with International Financial Reporting Standards and that the Auditor was planning to complete the audit process by early September 2019.  The Auditor’s report on the accounts would be made available to members and submitted to a future meeting of the IJB Audit Committee for consideration.

The report detailed the approval process and timetable in relation to approval of the IJB’s annual accounts.

It was proposed (a) that the annual accounts for 2018/19 be approved, subject to audit; (b) that it be noted that the Auditor was planning to complete the audit of the accounts by early September 2019 and that their report would be made available to all members and submitted to a future meeting of the IJB Audit Committee for detailed consideration; and (c) that the annual governance statement be approved for inclusion in the annual accounts. This was agreed.

DECIDED:

(a) That the annual accounts for 2018/19 be approved, subject to audit; 

(b) That it be noted that the Auditor was planning to complete the audit of the accounts by early September 2019 and that their report would be made available to all members and submitted to a future meeting of the IJB Audit Committee for detailed consideration; and 

(c) That the annual governance statement be approved for inclusion in the annual accounts.

The Chief Officer submitted a report relative to the Performance Management End of Year Report 2018/19.

The report intimated that data was not yet available for all performance measures to March 2019 and that the information detailed in the report was the most up-to-date available.

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

There were 65 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 32.5% of performance measures had red status, 12.5% had amber status and 55% had green status.

DECIDED:

(a) That the Performance Management End of Year Report 2018/19 for Renfrewshire HSCP be approved; and

(b) That the process to finalise the Renfrewshire HSCP Annual Performance Report 2018/19, which would be published on 31 July 2019 and submitted to the next meeting of the IJB to be held on 20 September 2019, be approved.

The Chief Officer submitted a report providing an overview of the year one performance against the four priorities of Renfrewshire’s NO TO Gender Based Violence Strategy (2018/21) and the strategic direction for year two.  

The report intimated that Equally Safe, Scotland’s strategy for preventing and eradicating violence against women and girls, was published in 2014 and updated in 2016.  The aim of the strategy was to ensure partnership working across the public, private and third sector in order to create a ‘strong and flourishing Scotland where individuals are equally safe and protected, and where women and girls live free from all forms of violence and abuse and the attitudes which perpetuate them’.

The implementation of Equally Safe was the responsibility of local Violence Against Women Partnerships and in Renfrewshire, the local multi-agency Gender Based Violence (GBV) Strategy Group provided an annual assessment to the Scottish Government against the Equally Safe Quality Standards and Performance Framework.  The Renfrewshire GBV Strategy Group published its first strategy in November 2018 and the vision was that ‘Renfrewshire is a place where GBV is not tolerated and where victims, perpetrators and communities are supported to address its causes and consequence.’

Appendix 1 to the report detailed the year one performance update; Appendix 2 to the report detailed the year two action plan; and the Women and Children First Annual Report 2018/19 formed Appendix 3 to the report.

DECIDED: That the update on the service delivered by Women and Children First and the ongoing work of the Gender Based Violence Strategy Group be noted.

The Chief Officer submitted a report relative to the Child Poverty (Scotland) Act 2017 which included a duty on local authorities and NHS Boards to commit to new actions to reduce child poverty, alongside key partners, and to report annually to the Scottish Government through publication of Local Child Poverty Action Reports (LCPAR), the first of which as due to be submitted to the Scottish Government by 30 June 2019.
The report intimated that the LCPAR was supported by the NHS Greater Glasgow & Clyde Child Poverty Report 2018/19, a copy of which was appended to the report.

It was noted that the Child Poverty (Scotland) Act 2017 set out targets to reduce the number of children experiencing the effects of poverty by 2020 and set interim targets to be met by 2023. The report detailed of the steps being taken by the HSCP, in partnership, to reduce child poverty.

DECIDED: 

(a) That the work undertaken in 2018/19 to support NHS Greater Glasgow & Clyde and Renfrewshire Council to meet their statutory duties to contribute to reductions in child poverty rates be noted;

(b) That the commitments within the LCPAR for all staff across HSCP services to have a duty to contribute towards tackling child poverty in 2019/20 be noted; and

 

(c) That the wider partner actions undertaken and planned to tackle child poverty and continue to influence development of these through appropriate local partnership structures be noted.

Under reference to item 8 of the Minute of the meeting of the IJB held on 22 March 2019, the Chief Officer submitted a report providing an update on the HSCP’s evolving Change and Improvement Programme including the ongoing service reviews.

The report provided an update on the four workstreams, being 1. optimising joint and integrated working and shifting the balance of care; 2. statutory requirements, national policy and compliance; 3. service reviews; and 4. delivering safe and sustainable services. 

DECIDED: That the content of the report be noted.

Under reference to item 9 of the Minute of the meeting of the IJB held on 22 March 2019, the Chief Officer submitted a report relative to the review of addiction services in Renfrewshire, commissioned in January 2018 by the Alcohol and Drug Partnership.

The report intimated that the review had been led by John Goldie, an independent reviewer, supported by a review team comprising core HSCP staff, third-sector, service-users and lived experience representation. 

It was noted that work was underway to implement all the recommendations from the review and that significant redesign of services would be required to ensure the recommendations were fully implemented.  The report provided an update on the main key areas.

DECIDED: That the content of the report be noted.

The Chief Officer submitted a report relative to the work underway to tender for a new contractor to provide medical services in the GP practice at Erskine Health Centre, Bargarran, Erskine as a result of the departure of the previous GP contractor from 1 March 2019.

The report intimated that NHS Greater Glasgow & Clyde had been looking after the patients of the former practice, as a directly managed practice (2c practice), from 2 March 2019 and that during this period, sufficient locum GP cover had been provided.  A range of media had been used to effectively communicate and engage with patients and staff on how this change affected them.  

The NHS Board had considered the four options available, being option1 – disperse patients; option 2 – allocate patients to an existing contractor; option 3 – tender for a new contractor; and option 4 – 2c practice, and it was decided that a tender for a new contractor be progressed to support continuation of services and minimise risk.

It was noted that all relevant tender documents had been prepared and the vacancy would be advertised in the BMJ and all GP practices in NHS Greater Glasgow & Clyde would be advised of the vacancy by email.  The procurement process was expected to run form June to October 2019 and thereafter an interview panel would be established to shortlist and interviews applicants and make a recommendation to the Chief Executive of NHS Greater Glasgow & Clyde as to how the new contract should be allocated.  The successful provider would be required to enter into a contract with NHS Greater Glasgow & Clyde on the terms of the General Medical Services Contract and a Primary Medical Services agreement.

The Chief Officer undertook to provide an update on this matter within the Change and Improvement Programme update report being submitted to the next meeting of the IJB to be held on 20 September 2019.

DECIDED:

(a) That the content of the report to tender for a new contractor be noted;

(b) That it be noted that until the new contract was awarded, the Heal Board/HSCP would continue to directly manage the GP Practice at Erskine Health Centre, Bargarran, Erskine; and

(c) That an update on this matter be included within the Change and Improvement Programme Update report being submitted to the next meeting of the IJB to be held on 20 September 2019.

The Head of Administration submitted a report requesting that the date of the next meeting of the IJB be changed from 13 September 2019 to 20 September 2019.

DECIDED: That the next meeting of the IJB be held at 10.00 am on 20 September 2019 in the Abercorn Conference Centre, Renfrew Road, Paisley.