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.

 

Frank Shennan (Greater Glasgow & Clyde Health Board) and Annie Hair (Trade Union Representative for Health Board).

 

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

 

The Minute of the meeting of the Integration Joint Board (IJB) held on 26 January 2024 was submitted.

DECIDED: That the Minute be approved.

The rolling action log for the IJB was submitted.

It was noted that a report relative to the term of office of the Chair and Vice Chair of the IJB and the IJB Audit, Risk and Scrutiny Committee would be submitted to the IJB following review of the Integration Scheme; a report relative to arrangements for future meetings would be considered later in the meeting and as such the action could be closed off; a report on the refreshed ADP Strategy and high-level delivery plan would be submitted to the IJB when detail was available; and information on respite services in Renfrewshire was contained in the Chief Officers’ Report which would be considered later in the meeting and as such the action could be closed off.

DECIDED: That the updates to the rolling action log be noted.

The Clerk advised that Frank Shennan’s term as a non-executive director with NHSGGC would cease at the end of May 2024 and that in order to ensure continuity until this role was recruited to or replaced substantively, the Health Board had advised that it would provide a deputy over the vacant period and Michelle Wailes was in attendance at this meeting. 

The Clerk further advised that Fiona Milne had intimated that she would be resigning her position as the unpaid carer representative on the IJB as of 31 March 2024 and that this would be the last meeting Fiona would attend.

It was noted that a report regarding membership would be submitted to the next meeting of the IJB.

On behalf of the IJB, the Chair thanked both Frank and Fiona for their contribution to the IJB. 

DECIDED: That the position be noted and that it be noted that a report regarding membership would be submitted to the next meeting of the IJB.

Under reference to item 4 of the Minute of the meeting of the IJB held on 26 January 2024, the Chief Officer submitted a report providing an update on recent key developments and operational activity and additional policy developments which would be built into future workplans, strategies and action plans.

The report intimated that the contents reflected an ongoing period of change and challenge, particularly within the financial circumstances faced by the IJB.

DECIDED: 

(a) That the range of key HSCP updates, as detailed in sections 4 to 7 of the report, be noted; and

(b) That the national policy updates, as detailed in sections 8 to 9 of the report, be noted.

The Chief Finance Officer submitted a report relative to the revenue budget position at 31 January 2024 and the projected year-end position for the year ending 31 March 2024. 

The report intimated that the cost pressures detailed in the report along with increasing demand created significant implications for service delivery in future years and that the IJB would be required to make difficult decisions in order to deliver recurring funding solutions.  

The report advised that the projected final outturn for 2023/24 was an overspend of £861k, taking into account the in-year drawdown of earmarked winter pressure reserves, and assumed a transfer of any in-year underspend at 31 March 2024 to earmarked reserves in line with Scottish Government funding arrangements in relation to Action 15, the Primary Care Improvement Programme and the Alcohol and Drug Partnership.

DECIDED:

(a) That the in-year position at 31 January 2024 be noted; and

(b) That the projected year-end position for 2023/24 be noted.

Under reference to item 7 of the Minute of the meeting of the IJB held on 26 January 2024, the Head of Strategic Planning & Health Improvement submitted a report relative to the Sustainable Futures programme.

The report provided updates on progress and related decisions which had been made on additional areas of scope within the Sustainable Futures programme and included an update on eligibility criteria and supporting assessment and care planning processes, community meals and soft facilities management.

The Chair proposed that an action be added to the action log for the next meeting that the IJB be briefed on the issues discussed at the meeting regarding Self-directed Support.

DECIDED:

(a) That the update provided on the increasingly challenging financial context for the IJB, as detailed in section 4 of the report, be noted; 

(b) That the update on the overall savings position, as detailed in section 5 of the report, be noted; 

(c) That the update provided on the review of eligibility criteria and assessment and care planning processes, as detailed in section 6 of the report, be noted;

(d) That the updates provided on work relating to community meals, soft facilities management and non-residential charging, as detailed in sections 7 to 9 of the report, be noted; 

(e) That the update on scoping strategic reviews and additional savings, as detailed in section 10 of the report, be noted; and

(f) That an action be added to the action log for the next meeting that the IJB be briefed on the issues discussed at the meeting regarding Self-directed Support.

Under reference to item 5 of the Minute of the meeting of the IJB held on 24 November 2024, the Head of Strategic Planning & Health Improvement submitted a report relative to final options for consideration in relation to the Sustainable Futures programme.

The report set out details on the findings of the impact assessment processes for four proposals, initially presented to the IJB in November 2023, and sought a decision on whether each proposal should now proceed to implementation. The report advised that consideration of the Mirin and Milldale proposal at this meeting had been paused following the lodging of a petition for judicial review, as detailed in section 2 of the report.

Councillor Cameron, seconded by Councillor Airlie-Nicolson, moved that the third bullet point be removed and replaced with: “The IJB agrees to reject the Milldale and Mirin merger proposal. In the midst of a social care crisis and the impending implementation of the National Care Services bill, the shape of future policy is uncertain, therefore the IJB agrees that the status quo should remain meanwhile.”

Councillor McMillan, seconded by Ann Cameron-Burns, moved as an amendment that “The IJB agrees to points 1, 2 and 3 of the recommendations as outlayed at section 2. The IJB however rejects the option to close the flexi-care service, rejects the option to close Montrose Care Home, approves the permanent closure of Montrose and Falcon Day Care Services for older people and approves the option to reduce the capacity of the Disability Resource Centre. IJB members request that officers bring back to a future board plans on how services currently ran from Montrose Care Home can be enhanced in order to secure its long term future. Also to bring back a report on how the Flexi Care service can be further improved to provide services to some of the most vulnerable members of our communities.”

Councillor McMillan and Ann Cameron-Burns then amended their amendment by deleting reference to point 3 being agreed.

The meeting adjourned at 11.15 am and reconvened at 11.45 am. 

Councillor McMillan and Ann Cameron-Burns, being the mover and seconder of the amended amendment, withdrew their amended amendment.

Margaret Kerr, seconded by Ann Cameron-Burns, moved that “Item 7, paras 7.1 and 7.2 set out that the IJB is in the process of seeking legal advice on the Judicial Review that was lodged with the Court of Session on 4 March 2024. The IJB papers, as provided to IJB members on Friday 15 March 2024, do not provide a conclusion to the engagement work that was unanimously approved by the IJB in November 2023 in respect of a proposed merger of Mirin and Milldale centres.

Members of the IJB have a responsibility for, among many other things, financial sustainability, sound financial management, and economic, efficient and effective use of resources. To do this the IJB members require full information and sufficient time to fully consider and assess the matters to make an informed decision. It is not possible to conclude on an informed basis at today’s IJB meeting. It is proposed that a fully informed decision should be made at a later (to be scheduled) date when the IJB members have been presented with officers’ complete findings and have had the information and time to make an informed decision.”

It was agreed that each of the recommendations in the report would be considered individually.

It was proposed that the first two recommendations in the report be noted. This was agreed unanimously. 

In relation to the third recommendation in the report, on the roll being called between Councillor Cameron and Councillor Airlie-Nicolson’s motion and Margaret Kerr and Ann Cameron-Burns’ amendment, the following members voted for the motion: Councillor Adam, Councillor Airlie-Nicolson, Councillor Cameron and Councillor McMillan.

The following members voted for the amendment: Ann Cameron-Burns, Margaret Kerr, John Matthews and Michelle Wailes.

4 members voted for the motion and 4 members voted for the amendment. There being an equality of votes and there being no casting vote available to the Chair both the motion and amendment were not approved. In terms of Standing Order 9.4, the Chair advised she would consider whether to adjourn consideration of the matter to the next meeting of the IJB or to a special meeting of the IJB to consider the matter further or refer the matter to dispute resolution as provided for in the Integration Scheme.

Councillor Adam, seconded by John Matthews, moved that the proposal to close the Flexicare service, as detailed in section 8 of the report, be approved.

Councillor McMillan, seconded by Councillor Airlie-Nicolson, moved as an amendment that the proposal to close the Flexicare service be rejected.

On the roll being called the following members voted for the motion: Councillor Adam, Margaret Kerr, John Matthews and Michelle Wailes.

The following members voted for the amendment: Councillor Airlie-Nicolson, Ann Cameron-Burns, Councillor Cameron and Councillor McMillan.

4 members voted for the motion and 4 members voted for the amendment. There being an equality of votes and there being no casting vote available to the Chair both the motion and amendment were not approved. In terms of Standing Order 9.4, the Chair advised she would consider whether to adjourn consideration of the matter to the next meeting of the IJB or to a special meeting of the IJB to consider the matter further or refer the matter to dispute resolution as provided for in the Integration Scheme.

Councillor Adam, seconded by Councillor Airlie-Nicolson, moved that the proposal to reduce internal care homes from three to two, as detailed in section 9 of the report, be approved and that Montrose Care Home be closed.

Councillor McMillan, seconded by Ann Cameron-Burns, moved as an amendment that the proposal to reduce internal care homes from three to two be rejected and that Montrose Care Home be not closed.

On the roll being called the following members voted for the motion: Councillor Adam, Councillor Airlie-Nicolson, Councillor Cameron, Margaret Kerr, John Matthews and Michelle Wailes.

The following members voted for the amendment: Ann Cameron-Burns and Councillor McMillan.

2 members having voted for the amendment and 6 members having voted for the motion, the motion was accordingly declared carried.

It was proposed that recommendation six in the report be approved. This was agreed unanimously. 

It was proposed that recommendation seven in the report be approved. This was agreed unanimously. 

DECIDED:

(a) That the overview of engagement undertaken between December 2023 and February 2024, including the process adopted for updating the IJB on proposal development, as detailed in sections 4 and 6 of the report, be noted;

(b) That the updates provided on the process of developments for EQIAs and options appraisals, as detailed in section 5 of the report, be noted;

(c) That there being an equality of votes and there being no casting vote available to the Chair both the motion and amendment were not approved. In terms of Standing Order 9.4, the Chair would consider whether to adjourn consideration of the matter to the next meeting of the IJB or to a special meeting of the IJB to consider the matter further or refer the matter to dispute resolution as provided for in the Integration Scheme;

(d) That there being an equality of votes and there being no casting vote available to the Chair both the motion and amendment were not approved. In terms of Standing Order 9.4, the Chair would consider whether to adjourn consideration of the matter to the next meeting of the IJB or to a special meeting of the IJB to consider the matter further or refer the matter to dispute resolution as provided for in the Integration Scheme;

(e) That the proposal to reduce internal care homes from three to two, as detailed in section 9 of the report, be approved and that Montrose Care Home be closed;

(f) That the proposal to permanently close Montrose and Falcon Day Services for Older People, as detailed in section 10 of the report, be approved; and

(g) That the proposal to reduce the capacity of the Disability Resource Centre, as detailed in section 11 of the report, be approved

The Chief Finance Officer submitted a report relative to the financial allocation and budgets made available to the IJB for 2024/25 by Renfrewshire Council and NHSGGC and outlining the main financial pressures on health and adult social care services. 

 

The report intimated that Renfrewshire IJB was a legal entity accountable for the stewardship of public funds and ensuring that its business was conducted under public sector best practice governance arrangements and that public money was safeguarded, properly accounted for and used economically, efficiently and effectively. The budget delegated by the two partner organisations was used by the IJB to commission services which were delivered by Renfrewshire HSCP. The principles of the funding allocated by the two partner organisations were set out in the Integration Scheme, however, utilisation of this funding was delegated to the IJB.

The report advised that in terms of the Integration Scheme, partner organisations should make appropriate arrangements to fund pay awards, contractual uplifts, the impact of demographic changes and determine efficiency targets as part of their respective budget setting processes. The role of the Section 95 Officer, the IJB Chief Finance Officer, included both the adherence to professional standards as well as compliance with section 95 of The Local Government (Scotland) Act 1973 and for the IJB this included the requirement to ensure a balanced budget was set. 

The report set out the implications of the Scottish Government budget for 2024/25, the Bill for which was passed on 27 February 2024 and provided an overview of the IJB’s budget allocation for 2024/25.

The report highlighted that the 2024/25 budget proposals had been presented on a ‘business as usual’ basis and did not include any assumptions as regards any extraordinary costs which might be incurred in respect of any significant outbreak of COVID-19. For accounting purposes these costs would be recorded separately with the assumption that costs would be recovered by partners, and ultimately by government.

DECIDED: 

(a) That the delegated Adult Social Care Budget for 2024/25, which formed Appendix 3 to the report, be noted;

(b) That it be noted that the delegated Health Budget for 2024/25, which formed Appendix 4 to the report, would be subject to any financial adjustments in relation to recurring budget adjustments at month 12 and any further funding allocated by the Scottish Government in respect of the impact of the 2024/25 pay award; and

(c) That the balanced budget outlined in section 9 of the report including the drawdown of required reserves in order to deliver a balanced budget for 2024/25 be agreed.

The Head of Strategic Planning & Health Improvement submitted a report providing updates on podiatry, primary care support and GP out of hours services, the hosted services which Renfrewshire HSCP delivered on behalf of the IJB.

The report intimated that hosted services were those managed and delivered by a single IJB on behalf of two or more IJBs within NHSGC. The IJB which hosted the services was responsible for the operational oversight of the services and, through its Chief Officer, was responsible for the operational management of the hosted services on behalf of each relevant IJB within the Health Board area. The IJB was also responsible for the strategic planning and operational budget of the hosted service.

DECIDED: That the hosted services performance for podiatry, primary care support and GP out of hours services for 2023/24 be noted. 

The Chair of the IJB Audit, Risk & Scrutiny Committee provided a verbal update on the business conducted at the meeting of the Committee held on 15 March 2024.

DECIDED: That the verbal update be noted.

Under reference to item 11 of the Minute of the meeting of the IJB held on 30 June 2023, there was submitted a report by the Clerk relative to the proposed timetable for future meetings of the IJB to June 2025 and the arrangements for these meetings.

DECIDED: 

(a) That it be noted that the next meeting of the IJB would be held at 10.00 am on 28 June 2024 and that this be a hybrid meeting in the Council Chamber, Renfrewshire Council, Renfrewshire House, Paisley;

(b) That the dates and times of IJB meetings in 2024/25, as detailed in paragraph 1.1 of the report, be approved and that it be agreed that these meetings would be hybrid meetings in the Council Chamber, Renfrewshire Council, Renfrewshire House, Paisley; and 

(c) That the dates and times of the IJB Audit, Risk and Scrutiny Committee in 2024/25, as detailed in paragraph 1.3 of the report be noted and that that it be noted that these meetings would be held remotely on MS teams.