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Meeting Details

Renfrewshire Health and Social Care Integration Joint Board.
20 Nov 2020 - 10:00 to 13:00
Occurred
  • Documents
  • Attendance
  • Visitors
  • Declarations of Interests

Documents

Agenda

Agenda
Notification
Committee Members
Membership

Councillor Jacqueline Cameron: Councillor Jennifer Adam-McGregor: Councillor Lisa-Marie Hughes: Councillor James MacLaren: Margaret Kerr: Dorothy McErlean: John Matthews: Frank Shennan: Karen Jarvis: Dr Shilpa Shivaprasad: Louise McKenzie: Diane Young: Alan McNiven: Fiona Milne: Stephen Cruickshank: John Boylan: Amanda Walton: Dr Stuart Sutton: David Leese: Sarah Lavers: John Trainer.

 

Councillor Jacqueline Cameron (Chair); and John Matthews (Vice Chair)

 
Present
Councillor Jacqueline Cameron, Councillor Jennifer Adam-McGregor, Councillor Lisa-Marie Hughes and Councillor James MacLaren) (all Renfrewshire Council); Margaret Kerr, Dorothy McErlean and Frank Shennan (all Greater Glasgow & Clyde Health Board); Dr Shilpa Shivaprasad (Registered Medical Practitioner (non-GP)); Louise McKenzie (Council staff member involved in service provision); Diane Young (Health Board staff member involved in service provision); Alan McNiven (third sector representative); Fiona Milne (unpaid carer residing in Renfrewshire); John Boylan (Trade Union representative for Council); Amanda Walton (Trade Union representative for Health Board); Dr Stuart Sutton (Registered Medical Practitioner (GP)); David Leese, Chief Officer (Renfrewshire Health and Social Care Partnership); Sarah Lavers, Chief Finance Officer (Renfrewshire Health and Social Care Partnership) and John Trainer, Chief Social Work Officer (Renfrewshire Council).
Chair
Councillor Jacqueline Cameron, Chair, presided.
In Attendance
Ken Graham, Head of Corporate Governance (Clerk) and Elaine Currie, Senior Committee Services Officer (both Renfrewshire Council); Christine Laverty, Head of Mental Health, Addictions and Learning Disability Services, Jackie Dougall, Head of Health and Social Care (West Renfrewshire), Shiona Strachan, Acting Head of Health and Social Care (Paisley), Frances Burns, Head of Strategic Planning and Health Improvement, Jean Still, Head of Administration, James Higgins, Project Officer, David Fogg, Service Improvement Manager, Lorna Finnie, Change and Improvement Officer and John Miller, Communications Officer (all Renfrewshire Health and Social Care Partnership); and John Cornett, Audit Director and Adam Haahr, Audit Manager (both Audit Scotland).
Sederunt
Dr Stuart Sutton joined the meeting during consideration of the following item of business.
Sederunt
John Trainer joined the meeting during consideration of the following item of business.
Sederunt
Dorothy McErlean left the meeting during the following item of business.
Valedictory
The Chair intimated that this would be David Leese’s last meeting of the IJB. She made reference to David’s various roles in his 30 years’ service with the NHS. She thanked David for all his assistance to her since being first elected as a Councillor and being appointed as the Chair of the IJB. On behalf of the IJB she wished David best wishes for the future.

David thanked the Chair, members of the IJB and his staff for their kind comments and work undertaken and wished everyone the best for the future.
Standard Items
Recording of Meeting
This meeting will be recorded for subsequent broadcast via the Council's internet site. If you have any queries regarding this please contact Committee Services on 0141 618 7111. To find the recording please follow the link which will be attached to this agenda once the meeting has concluded
Prior to the commencement of the meeting the Chair intimated that this meeting of the IJB would be recorded and that the recording would be available to watch on both the Council and HSCP websites.
Items Of Business
Apologies
Apologies from members.
John Matthews (Greater Glasgow & Clyde Health Board) and Karen Jarvis (Registered Nurse).
Declarations of Interest
Members are asked to declare an interest in any item(s) on the agenda and to provide a brief explanation of the nature of the interest.
There were no declarations of interest intimated prior to the commencement of the meeting.


Prior to the start of the meeting the Chair advised that this would be David Leese’s final meeting as Chief Officer and advised that Shiona Strachan would take up the position of Interim Chief Officer on 1 December 2020.
1 Minute
Minute of meeting of the Integration Joint Board (IJB) held on 2 October 2020.
1
The Minute of the meeting of the Integration Joint Board (IJB) held on 2 October 2020 was submitted.

In relation to item 10 – Renfrewshire HSCP Winter Plan 2020/21 - the Chief Officer updated members on this year’s flu vaccination programme.

DECIDED: That the Minute be approved.
Rolling action log.
2
The rolling action log for the IJB was submitted.

DECIDED: That the rolling action log and updates be noted.
Report by Chief Officer.
3
Under reference to item 3 of the Minute of the meeting of this Joint Board held on 2 October 2020, the Head of Administration submitted a report providing an update on membership of the IJB Audit, Risk and Scrutiny Committee.

The report intimated that, following the IJB meeting on 2 October 2020, it had been suggested that Diane Young replace David Wylie as a non-voting member on the IJB Audit, Risk and Scrutiny Committee.

DECIDED: That it be agreed that Diane Young take the role of a non-voting member on the IJB Audit, Risk and Scrutiny Committee.
Report by Chief Finance Officer.
4
Under reference to item 5 of the Minute of the meeting of the IJB held on 26 June 2020, the Chief Finance Officer submitted a report relative to the audited annual accounts for the IJB for 2019/20, a copy of which was appended to the report.

The report intimated that Audit Scotland had provided an audit opinion which was free from qualification. It was noted that Audit Scotland had also submitted a report to the IJB Audit, Risk and Scrutiny Committee held on 13 November 2020 which detailed matters arising over the course of the audit.

Margaret Kerr, as Chair of the IJB Audit, Risk and Scrutiny Committee, advised that the Audit, Risk and Scrutiny Committee recommended approval of the audited accounts 2019/20 for signature in accordance with the Local Authority Accounts (Scotland) Regulations 2014. Margaret also advised that the Audit Director had thanked the Chief Finance Officer and her team, for their help and support throughout the process and had advised that the quality of the working papers provided during the audit process were of a very high standard.  

DECIDED: That the audited annual accounts 2019/20 be approved for signature in accordance with the Local Authority Accounts (Scotland) Regulations 2014.
Report by Chief Finance Officer.
5
Under reference to item 6 of the Minute of the meeting of the IJB held on 20 March 2020, the Chief Finance Officer submitted a report providing an update on the financial outlook for 2021/22.

The report set out the Chief Finance Officer’s estimated financial outlook for the IJB for 2021/22; outlined the main financial pressures on health and adult social care services; detailed the potential implications of the Chief Finance Officer’s current assumptions regarding the anticipated budget pressures for 2021/22; provided detail in relation to the medium-term outlook and the financial sustainability of the IJB’s medium-term financial outlook; the delegated health budget 2020/21; and cost pressures and demand.

The report intimated that in line with the approach taken in the Medium-term Financial Plan, a scenario-based approach continued to be adopted to estimate future cost pressures and demand. Current projections for the period 2021/22 to 2025/26 included a wide range of assumptions in respect of key cost pressures and demand, highlighting a potential budget gap within a range of £46.5 million to £69.2 million for this period. This assumed budget gap did not take into account any potential additional funding from either the Scottish Government or partner organisations and was prior to any mitigating action being taken. Appendices 1 to 3 of the report set out the four scenarios to illustrate the potential financial impact assuming minimum, medium, high and worst-case scenario increases.

In relation to Audit Scotland’s key recommendation, detailed in section 6.12.3 of the report, it was noted that Audit Scotland were not recommending that the IJB build up general reserves, but were instead focusing the IJB’s attention on financial sustainability in the medium-term. The Chief Finance Officer advised that her request would be that the IJB continue to work to create a move towards achieving a target of 2% for general reserves.

It was noted that development sessions would be held in December 2020 and January 2021 for members to discuss the financial planning strategy for 2020/21 including emerging savings proposals. 

DECIDED:

(a) That the assumptions and context of the financial outlook for 2021/22 and the levels of uncertainty that existed in relation to these assumptions, and the ongoing expectation of the IJB being required to continue to plan for further significant budget gaps going forward, be noted;

(b) That it be noted that the potential financial and economic impact of COVID-19 represented a significant additional risk to the IJB and the wider public sector;

(c) That the significant disruption to the IJB’s delivery of its 2020/21 financial plan and transformation changes to bring forward and develop the second tranche of savings for 2021/22 and beyond through the renewal programme due to COVID-19 be noted; 

(d) That it be agreed that Audit Scotland’s key recommendation from their annual audit report 2019/20, as highlighted in section 6.12 of the report, be taken forward, ‘The board should remain focussed on the financial challenges facing the IJB and continue to ensure decisions are taken to support medium and long-term financial sustainability;

(e) That in order to provide further financial resilience, it be agreed that the IJB continue to work towards its agreed strategy to establish its targeted level of general reserves, as detailed in sections 6.3 to 9.6 of the report; and

(f) That, as detailed in paragraph 9.12 of the report, it be agreed to prudently progress 2021/22 financial planning on the basis of a range of funding scenarios from partner organisations from a reduction of 1% to an increase of 2%.
Report by Chief Finance Officer.
6
The Chief Finance Officer submitted a report relative to the revenue budget position at 30 September 2020 and the projected year-end position for the year ended 31 March 2021.

The report intimated that as highlighted to members, the impact of COVID-19 on services delivered by the HSCP had been unprecedented. It had required a significant degree of service change within a short period of time, ultimately having a substantial financial impact, the extent of which would become clearer as financial year 2020/21 progressed. Additional uncertainty remained over the HSCP’s financial position due to the continually changing situation; the potential for future spikes in demand for services which could create additional delivery and financial pressures; and the associated impact of these on the HSCP’s transformation and savings plans, which required ongoing review and realignment. 

The table in paragraph 3.2 of the report included the consolidated summary members were familiar with plus an added level of detail showing the current estimated cost to the HSCP of the response to COVID-19. This provided clarity of the financial impact of COVID-19 on the delegated 2020/21 IJB budget.

The IJB year-to-date position was an underspend of £20,000 and the projected outturn for 2020/21 was an overspend of £134,000. This position included the net actual and estimated costs in relation to COVID-19 and was prior to the transfer of any ringfenced balances to general and earmarked reserves at the financial year end.  The key pressures were highlighted in section 4 of the report.

The revenue budget position of the HSCP and Health for the financial period 1 April to 16 October 2020 and 30 September 2020, respectively, and the year-end position was detailed in Appendices 1 and 2 to the report; the revenue budget position of Adult Social Care and ‘other delegated services’ for the period 1 April to 16 October 2020 and the year-end position was detailed in Appendices 3 and 4 to 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 Scottish Government funding streams; Appendix 8 to the report detailed the projected movement in reserves; Appendices 9 and 10 to the report detailed the vacancy position for the HSCP as at 16 October 2020 by client group and job description; and the letter from the Assistant Director of Finance, NHS Greater Glasgow & Clyde formed Appendix 11 to the report.

The report also provided information on Scottish Government funding 2020/21; the delegated health budget update 2020/21; reserves; and a summary of the 2020/21 Scottish Living Wage.

DECIDED:

(a) That the in-year position as at 30 September 2020 be noted;

(b) That the projected year-end position for 2020/21 be noted; and

(c) That the current estimated financial assessment of the potential revenue consequences of the COVID-19 pandemic for 2020/21 be noted.
Report by Chief Officer.
7

The Chief Officer submitted a report providing an update on the HSCP’s Recovery and Renewal Programme which was being implemented alongside the ongoing response to COVID-19 and related impacts of the pandemic on the IJB’s financial planning processes.

The report provided information on Strand 1 activity which was focussed on the development of a community-led approach to improving health and wellbeing; service operational updates; information on Strand 2 activity, Older People’s Services Review; an update in relation to Care at Home; and financial planning for financial year 2021/22 and alignment with recovery and renewal activity.

The final report by Journey Associates ‘Renfrewshire Older People’s Services Review’ was appended to the report.

The report also provided an update of the impact of COVID-19 on the IJB’s agreed Medium-term Financial Plan approach, which set out a two-tiered process for delivering savings in financial year 2020/21 prior to a strategic approach to transformation contributing to financial sustainability from financial year 2021/22 onwards. COVID-19 had significantly impacted upon the HSCP’s ability to implement savings agreed by the IJB and had delayed opportunities to commence wider transformation activity. The HSCP proposed the extension of the two-tiered approach into financial year 2021/22 to include the identification of targeted savings opportunities and to recognise the continued need to prioritise COVID-19 response and recovery prior to entering a renewal phase.


DECIDED:

(a) That the progress made in implementing the Strand 1 community-led approach to improving health and wellbeing in Renfrewshire with partners in the Strategic Planning Group be noted; 

(b) That the complex context influencing the HSCP’s scoping and progression of Strand 2 renewal activity and the need to maintain flexibility in approach to transformation to enable the ongoing delivery of the HSCP’s operational priorities be noted;

(c) That the contents of the Journey Associates final report delivered as part of the engagement phase of the Older People’s review be noted;

(d) That the progress made on taking forward change activity with Care at Home be noted; and

(e) That the extension of the Medium-term Financial Plan’s two-tiered approach into financial year 2021/22 and the process set out for developing savings options for the next financial year be agreed.

Report by Chief Officer. (not available - copy to follow)
8
Under reference to item 5 of the Minute of the meeting of this IJB held on 2 October 2020, the Chief Officer submitted a report providing an update on the partnership’s operational response to COVID-19 and ongoing recovery activity.

The report provided information on care homes - older people; PPE; the flu vaccination programme; day support and respite provision; visiting arrangements for adult and older people mental health impatient services; and the Alcohol and Drug Commission.

Members then heard from the Interim Chief Officer and the Head of Mental Health, Addictions and Learning Disability Services who provided updates in relation to their specific service.

DECIDED: That the operational service updates provided and the HSCP’s continued prioritisation of the response to COVID-19 and associated recovery activity with a fast-changing and fluid context be noted.
Report by Chief Officer.
9
The Chief Officer submitted a report relative to the Performance Management Mid-year Report 2020/21 covering the period April to September 2020. The full scorecard which updated all performance measures was appended to the report.

There were 68 performance indicators of which 37 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 exceeds target. At the midyear point, the scorecard detailed the status of the 37 indicators which had targets set against them. It was noted that 10 had red status, 4 had amber status and 23 had green status. 

DECIDED: That the Performance Management Mid-year Report 2020/21 for Renfrewshire HSCP be approved.
Report by Chief Officer.
10
The Chief Officer submitted a report providing an update on the non-financial governance arrangements in place from 1 April 2019 to 30 September 2020, as detailed in the appendix to the report.

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

DECIDED: That the content of the report be noted.
Report by Chief Social Work Officer.
11
The Chief Social Work Officer submitted a report relative to the 2019/20 annual report by the Chief Social Work Officer (CSWO). In Renfrewshire this role was held by the Head of Child Care and Criminal Justice, Renfrewshire Council. 

The report provided an overview of the role of the CSWO, outlined local arrangements for the discharge of the functions of the post, highlighted key areas of activity of the CSWO locally, detailed the issues and challenges encountered during 2019/20 and provided an overview of activities undertaken by social work services.

A copy of the annual report by the CSWO was appended to the report. The report intimated that the scope of the CSWO role covered all social work and social care services, whether provided directly by the local authority, or in partnership with others, including the health and social care partnership. Where these services were purchased or commissioned from external providers, the CSWO had responsibility to advise on the specification, quality and standards of services commissioned.

DECIDED

(a) That the key activities outlined in the CSWO annual report be noted; and

(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.
Note that the next meeting of the IJB will be held at 10.00 am on 29 January 2021.
12
DECIDED: That it be noted that the next meeting of the IJB would be held remotely by MS teams at 10.00 am on 29 January 2021.

Supplementary Agenda

Agenda
Notification
Committee Members
Standard Items
To Follow Item

I refer to the agenda for tomorrow's meeting and enclose the undernoted report relative to item 8 previously marked 'to follow'.

Declarations of Interests

Member NameItem Ref.DetailsNature of DeclarationAction
No declarations of interest have been entered for this meeting.

Visitors

Visitor Information is not yet available for this meeting