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Meeting Details

Renfrewshire Health and Social Care Integration Joint Board.
15 Sep 2017 - 10:00 to 12:00
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  • Attendance
  • Visitors
  • Declarations of Interests

Documents

Agenda

Agenda
Notification
Committee Members
Membership

Councillor Jacqueline Cameron: Councillor Jennifer Adam-McGregor: Councillor Lisa-Marie Hughes: Councillor Scott Kerr: Dr Donny Lyons: Morag Brown: Dorothy McErlean: Linda de Caestecker: Karen Jarvis: Alex Thom: Liz Snodgrass: David Wylie: Alan McNiven: Helen McAleer: Stephen Cruickshank: John Boylan: Graham Capstick: Dr Stuart Sutton: David Leese: Sarah Lavers: Peter Macleod.


Councillor Jacqueline Cameron (Chair) and Dr Donny Lyons (Vice Chair)

 
Present
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); G Capstick (trade union representative for health staff); Stephen Cruickshank (service user residing in Renfrewshire); Karen Jarvis (Registered Nurse); Helen McAleer (unpaid carer residing in Renfrewshire); Alan McNiven (third sector representative); Liz Snodgrass (Council staff member involved in service provision); Dr Stuart Sutton (Registered Medical Practitioner (GP)); Alex Thom (Registered Medical Practitioner (non-GP)); David Wylie (Health Board staff member involved in service provision); 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).
Chair
Councillor Jacqueline Cameron, Chair, presided.
Apology
Dorothy McErlean (Greater Glasgow & Clyde Health Board).
In Attendance
Ken Graham, Head of Corporate Governance (Clerk) and Elaine Currie, Senior Committee Services Officer (both Renfrewshire Council); and Iain Beattie, Head of Health and Social Care (Paisley), Caroline Burling, Acting Head of  Mental Health, Addictions and Learning Disability Services, Mandy Ferguson, Head of Health and Social Care (West Renfrewshire), Fiona Mackay, Head of Strategic Planning & Health Improvement and Jean Still, Head of Administration (all Renfrewshire Health and Social Care Partnership).
Order of Business
In terms of Standing Order 4.1 (iii), the Chair intimated that she proposed to alter the order of business to facilitate the conduct of the meeting by considering item 8 of the agenda after item 2 of the agenda.
Adjournment
The meeting adjourned at 11.05 am and reconvened at 11.15 am.
Audited Annual Accounts 2016/17
5

Under reference to item 5 of the Minute of the meeting of this IJB held on 23 June 2017 the Chief Finance Officer submitted a report relative to the audited annual accounts for the IJB for 2016/17, a copy of which formed the appendix 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 Committee held earlier in the morning which detailed matters arising over the course of the audit.

The Chair of the IJB Audit Committee advised that the Audit Committee recommended approval of the audited accounts 2016/17 for signature in accordance with the Local Authority Accounts (Scotland) Regulations 2014. 

It was proposed that the Chief Finance Officer submit a report to a future meeting of the IJB clarifying the position in relation to the IJB’s ‘general reserves’ and ‘earmarked reserves’ in terms of the IJB Reserves Policy.
       
DECIDED: 

(a) That the audited annual accounts 2016/17 be approved for signature in accordance with the Local Authority Accounts (Scotland) Regulations 2014; and

(b) That the Chief Finance Officer submit a report to a future meeting of the IJB clarifying the position in relation to the IJB’s ‘general reserves’ and ‘earmarked reserves’ in terms of the IJB Reserves Policy.

Financial Plan 2018/19 to 2020/21
6
The Chief Finance Officer submitted a report relative to the Financial Plan 2018/19 to 2020/21 which provided an estimate on the HSCP’s projected position moving into 2018/19 and the medium term financial outlook to 2020/2021, a copy of which formed the appendix to the report.

The report detailed the key messages; the current financial position; budget strategy assumptions; projected cost pressures 2018/19 to 2020/21; and the medium term financial strategy.

DECIDED: 

(a) That the assumptions and context of the financial plan 2018/19 to 2020/21 and the level of uncertainty that existed in relation to a range of these assumptions be noted;

(b) That the medium term outlook for the IJB in the context of current forecasts and the expectation of further significant reductions for the IJB through to 2020 be noted;

(c) That the medium term financial plan and associated financial planning principles be approved;

(d) That the Financial Plan 2018/19 to 2020/21, as detailed in the appendix to the report, be approved; and

(e) That it be noted that the Chief Officer and Chief Finance Officer would continue to monitor the actual position and update the Financial Plan as assumptions become clear and that the IJB be advised of the updates in due course.
Sederunt

Councillor Kerr, Stephen Cruickshank and Alan McNiven left the meeting prior to consideration of the following item of business.

 

 

Adjournment
The meeting adjourned at 12.30 pm and reconvened at 12.35 pm.
Sederunt
Dr Donny Lyons left the meeting during consideration of the following item of business.
Audit Scotland Report - Self-Directed Support
12

The Chief Officer submitted a report relative to the second Audit Scotland report on Self-Directed Support (SDS), a copy of which formed Appendix 1 to the report.

SDS described the mechanism by which people could have choice and control over
the social care they received. It gave people control over an individual budget and
allowed them to choose how it was spent on support which met their agreed social
care outcomes. The Social Care (Self-Directed Support) (Scotland) Act 2013 placed a duty on local authorities to offer four options to eligible people, at the point of
assessment, to self-direct their support. The Audit Scotland report highlighted 11
recommendations for authorities and detailed local progress in terms of implementing SDS.

The report intimated that in addition to the main report, Audit Scotland had also produced three supplements – a case study, the audit methodology and survey results, and a checklist for councillors and board members. These supplements formed Appendices 2 to 4 of the report.

DECIDED:

(a) That the key recommendations made by Audit Scotland for implementation
by HSCPs and/or Councils be noted;

(b) That the local developments in relation to implementing Self-Directed Support and the HSCP’s work to develop an improvement plan subsequent to the completion of its current self-evaluation exercise be noted;

(c) That the content of the supplementary “Checklist for councillors and board
members” which had been produced by Audit Scotland be noted; and

(d) That it be noted that this report would also be submitted to Renfrewshire
Council’s Audit, Risk and Scrutiny Board meeting to be held on 26 September 2017.

Sederunt
Alex Thom left the meeting prior to consideration of the following item of business.
Standard Items
Further Information
This is a meeting which is open to members of the public. 

A copy of the agenda and reports for this meeting will be available for inspection prior to the meeting at the Customer Service Centre, Renfrewshire House, Cotton Street, Paisley and online at www.renfrewshire.cmis.uk.com/renfrewshire/CouncilandBoards.aspx

For further information, please either email
democratic-services@renfrewshire.gov.uk or telephone 0141 618 7112.
Members of the Press and Public
Members of the press and public wishing to attend the meeting should report to reception where they will be met and directed to the meeting.
Items Of Business
Apologies
Apologies from members.
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.
1 Minute
Minute of meeting of the Integration Joint Board (IJB) held on 23 June 2017.
1
The Minute of meeting of the Integration Joint Board (IJB) held on 23 June 2017 was submitted.  

DECIDED: That the Minute be approved.
Report by Head of Administration.
2
The Head of Administration submitted a report advising that Dr Linda de Caestecker had replaced John Legg as a health board voting member on the IJB.

DECIDED: That it be noted that Dr Linda de Caestecker had replaced John Legg as a health board voting member on the IJB.
Report by Chief Finance Officer.
4
The Chief Finance Officer submitted a report relative to the revenue and capital budget positions from 1 April to 21 July 2017 for Social Work and from 1 April to 31 July 2017 for the Health Board, as detailed in appendices 1 and 2 to the report.  

The report provided an update in respect of the Health Board contribution to the IJB for 2017/18 and the implementation of the Living Wage for 2017/18.

The overall revenue position for the (HSCP) at 31 July 2017 was a breakeven position as detailed in the report.  The achievement of the in-year breakeven position and a year-end breakeven position was dependent on the application of reserves carried forward from 2016/17 for both the adult social care budget and the health services budget and delivery of the delegated health budget savings plans, which had been approved by the IJB at its meeting held on 23 June 2017.

Overall, social work adult services were currently reporting a breakeven position.  However this had only been achieved from the application of reserves carried forward from the 2016/17 budget allocation and a proportion of the additional £4.4m of resources made available by the Council as part of their 2017/18 budget allocation to the IJB for adult social care.

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 GP prescribing position; Appendix 6 to the report detailed the reserve balances as at 31 July 2017; Appendix 7 to the report detailed the movement from the 2016/17 closing budget to the budget per the allocation letter; and the letter outlining the final settlement from NSHGG&C for 2017/18 formed Appendix 8 to the report.

DECIDED

(a) That the current revenue budget position as at 31 July 2017 report be noted;

(b) That the progress of the implementation of the Living Wage for 2017/18 be noted;

(c) That the application of the Partnership’s reserves, as detailed in paragraphs 4.1 and 5.1 of the report, be approved; and

(d) That the proposal in respect of agreeing the Health Board contribution to the IJB for 2017/18, as detailed in paragraphs 9.2 and 9.6 of the report, be approved.
Report by Chief Finance Officer.
Report by Chief Officer.
7
The Chief Officer submitted a report updating the HSCP’s performance framework for 2017/18.

The report intimated that the indicators in the HSCP Performance Scorecard had been reviewed and included new national indicators where data was available.  Targets had also been reviewed and updated to ensure that they were realistic and improvement in the performance could be evidenced.  

The first HSCP Annual Performance Report 2016/17 had been finalised and published on the HSCP website.  The report summarised what had been achieved in the first year and assessed performance in the context of arrangements set out in the Strategic Plan 2016/19 and Financial Statement and included achievements and challenges throughout the year.

The draft scorecard detailing all proposed national and local indicators for 2017/18, set against the nine national outcomes, formed Appendix 1 to the report.  An update on the Podiatry Service, which was hosted in Renfrewshire for all NHSGG&C, formed Appendix 2 to the report and data on teenage pregnancy and sexual health formed Appendix 3 to the report.

DECIDED: 

(a) That the indicators and targets set out in the scorecard for 2017/18, as detailed in Appendix 1 to the report, be agreed;

(b) That the Performance Management Framework for 2017/18 for the HSCP be approved; and

(c) That the performance updates for podiatry and teenage pregnancy, as detailed in appendices 2 and 3 to the report, be noted.
Report by Chief Officer.
8
Under reference to item 10 of the Minute of the meeting of the IJB held on 18 March 2016 the Chief Officer submitted a report updating progress on Renfrewshire HSCP’s Participation, Engagement and Communication Implementation Plan for 2016/19, a copy of which formed the appendix to the report.

The report detailed the proposed actions for 2017/18.

The Head of Strategic Planning & Health Improvement delivered a short presentation which covered the new HSCP branding and logo; information on the effective use of social media; the production of a bi-annual newsletter to update on the work of the HSCP and key priorities for the year ahead; and the launch of the Renfrewshire HSCP website on 28 August 2017 

DECIDED:

(a) That the progress made in implementing the Renfrewshire HSCP Participation, Engagement and Communication Strategy in 2016/17 be noted; 

(b) That the actions planned for 2017/18 be approved; and

(c) That it be noted that an annual update would be provided to the IJB.
Report by Chief Officer (copy to follow)
3

The Chief Officer submitted a report providing an update on the two day services for adults with learning difficulties operated by Capability Scotland, on behalf of the Renfrewshire Health and Social Care Partnership (HSCP), in Renfrewshire at Whitehaugh and West Lane Gardens, Paisley.

The report intimated that both these services were building-based and remained popular with current service users.  In line with the Scottish Government’s Learning Disability Strategies ‘The Same as You’ and ‘Keys to Life’, Renfrewshire learning disability day provision had over recent years managed a planned move away from these traditional centre-based services towards a more inclusive, community-based services approach.  As part of this work, Renfrewshire Council, the former Community Health Partnership (CHP) and the HSCP had worked closely with Capability Scotland, who operated community-based service models elsewhere in Scotland, to explore all options for modernising these two day services.

In July 2017 Capability Scotland served formal notice to the HSCP Chief Officer on their intention to withdraw from their current contract on 20 October 2017, noting that the current service model had accrued significant annual financial deficits and was no longer seen by Capability Scotland to be financially viable going forward.  

 

 

 

 

The Chief Officer had been working with the provider to discuss the continuation of this service within the terms of their contract and to explore a viable longer term alternative service model.  Capability Scotland had re-stated their intention to cease provision of this service but had agreed it would continue until 31 January 2018 subject to the IJB meeting the financial shortfall the provider would incur during this period.  This arrangement would ensure that the provider met their contractual requirement to minimally provide six months notice and would allow the HSCP sufficient time to ensure a smooth, managed transition for service users.

The report further intimated that the Chief Officer, in liaison with the Chair and Vice Chair of the IJB, would continue discussions with local service users, carers and Renfrewshire Council to quickly explore if Capability Scotland could develop an alternative service model in Renfrewshire which was financially viable in line with national policy direction and in a way that met the needs of our service users; progress planning to extend the existing HSCP community network services that would meet the needs of many of the Capability Scotland day centre users; and ensure smooth, managed transition arrangements were in place in advance of 31 January 2018 to support each service user to decide how they wanted to use their personal directed support budget to secure alternative services.

In light of concerns raised by service users and carers, a special meeting of Renfrewshire Council had been held on 30 August 2017 to discuss Capability Scotland’s decision to withdraw from their current contract.  The Head of Corporate Governance, Renfrewshire Council, had written to the Chief Officer advising him of the motion approved unanimously at the meeting and asking that he consider the terms of the Council’s decision and how this would be taken forward by Renfrewshire HSCP.  A copy of this letter formed the appendix to the report. 

It was proposed that the Chief Officer and Chief Finance Officer revisit the IJB finances and reserves to ensure individual service users received the maximum level of support they required; that the Chief Officer submit a report to the next meeting of the IJB outlining a strategy for the IJB to have in place a needs-led commissioning plan involving carers and that the strategy used language that was easily understandable to service users and their carers; and that the Chief Officer submit a report to the next meeting of the IJB relative to the future use of West Lane Gardens.  This was agreed.

Councillor Kerr being the mover of an amendment which failed to find a seconder requested that his dissent be recorded.

DECIDED:

(a) That Capability Scotland’s intention to cease their current contract on 31 January 2018; the local and national factors which had led to Capability Scotland’s view that their current service model was no longer proving financially viable, and how this had been received by its service users and carers be noted;

(b) That it be agreed that Renfrewshire IJB would meet the £34,500 cost shortfall identified by Capability Scotland to enable Capability Scotland to continue its current contract with the Council until 31 January 2018;

 

(c) That it be agreed that the Chief Officer, in consultation with the Chair and Vice Chair of the IJB, would quickly progress discussions to explore if Capability Scotland could develop an alternative community-based service model in Renfrewshire;

(d) That it be agreed that Renfrewshire HSCP would progress plans to extend the existing HSCP Learning Disability Community Network Service should Capability Scotland not be able to provide such a model that was affordable and deliverable by 31 January 2018;

(e) That it be noted that work would continue to ensure planned transition arrangements were in place as soon as possible that were person-centred and which fully reflected the needs of service users;

(f) That Renfrewshire Council’s position on Capability Scotland’s decision to end their current contract, formally agreed at the special meeting of Renfrewshire Council held on 30 August 2017, be noted;

(g) That it be agreed that the Chief Officer write to Renfrewshire Council on behalf of the IJB to formally note their position and next steps; 

(h) That the Chief Officer and Chief Finance Officer revisit the IJB finances and reserves to ensure individual service users received the appropriate level of support they required; and

(i) That the Chief Officer submit a report to the next meeting of the IJB outlining a strategy for the IJB to have in place a needs-led commissioning plan involving carers and that the strategy used language that was easily understandable to service users and their carers and the future use of West Lane Gardens.

Report by Chief Officer.
9
The Chief Officer submitted a report summarising and bringing together the strategic planning and commissioning activity in Renfrewshire HSCP.
The report intimated that planning and commissioning were cross-cutting activities, linking strategic and financial planning with service delivery.  The process involved assessing desired outcomes, considering options and planning and implementing the nature, range and quality of future services.  

The report detailed how strategic planning and commissioning linked with the wider planning systems and how planning and commissioning would progress over the next year.

In preparation for the pending inspection of Adult Services, a self-evaluation had been carried out covering planning and commissioning.  A review of the Strategic Needs Assessment was being undertaken and a market position statement would be developed to direct and influence HSCP and commissioned services.

DECIDED:

(a) That the current planning and commissioning activity be noted; and

(b) That the planned activity in this area over the next 12 months be approved.
Report by Chief Officer.
10
The Chief Officer submitted a report relative to the requirement for the West of Scotland to produce a first Regional Delivery Plan by March 2018 and seeking the support of IJBs to work collaboratively to achieve the best outcomes delivered sustainably for the citizens across the West.

The report intimated that the Health and Social Care Delivery Plan, published by the Scottish Government in December 2016, set out the importance of delivering better care; better health and better value.  It also signalled the need to look at services on a population basis and to plan and deliver services that were sustainable, evidence-based and outcomes focussed.

At a regional level, the Scottish Government had commissioned Regional Delivery Plans to be developed, encompassing a whole-system approach to the delivery of health and social care for each of the three regions, being North, East and West.  To take forward the national and regional approach, five NHS Board Chief Executives had been appointed to the role of the National or Regional Implementation Leads.

To progress a Regional Delivery Plan it was essential that this be linked to nation planning for specialist services, local planning within Health Boards and local planning by and within IJBs to ensure that we planned effectively for the wider population.  Regional Delivery planning was in its early stages and was an evolving process which would be achieved by working together across the different organisations in a whole systems approach to set out the story for the West of Scotland, describing the current challenges and considering the opportunities to transform care models to meet the future requirements of our population and improve health.

DECIDED:

(a) That it be noted that the Chief Officer would contribute towards and represent Renfrewshire IJB in this collaborative work towards achieving our shared aims for the population we serve; and

(b) That it be noted that further updates on this work would be brought to the IJB.
Report by Chief Officer.
11

The Chief Officer submitted a report relative to the new National Health and Social Care Standards introduced by the Cabinet Secretary for Health and Sport, a copy of which formed the appendix to the report.

The report intimated that the new standards set out what people should expect when using health, social care or social work services in Scotland and sought to provide better outcomes for everyone; to ensure that individuals were treated with respect and dignity; and that the basic human rights we are all entitled to were upheld.

The standards did not replace previous standards and outcomes relating to healthcare produced under Section 10H of the National Health Service (Scotland) Act 1978 but would replace the National Care Standards published in 2002 under Section 5 of the Regulation of Care (Scotland) Act 2001.

From 1 April 2018 these standards would be taken into account by the Care Inspectorate, Healthcare Improvement Scotland and other scrutiny bodies in relation to inspections and registration of health and care services.  The HSCP would undertake a range of activities over the next few months in the lead-up to the new standards being implemented to raise awareness and ensure that services were preparing for the change in focus of inspection and scrutiny activity from April 2018.

 DECIDED: That the launch of the new standards and the intentions set out in the report regarding the HSCP’s plans to ensure that practitioners, managers and service users were aware of and work to the new standards be noted.

Report by Chief Officer (copy to follow)
Report by Chief Officer.
13
The Chief Officer submitted a report relative to the Renfrewshire IJB Property Strategy, a copy of which formed the appendix to the report.

The report intimated that following the establishment of the IJB and the HSCP there was an opportunity to review the approach taken to strategic planning and utilisation of the estate available to the HSCP to support the aims of integration and delivery of effective, efficient health and social care services in Renfrewshire.

NHSGG&C and Renfrewshire Council collectively owned, leased or otherwise utilised a significant amount of property within the Renfrewshire area where health and social care functions were carried out.  Whilst the IJB was not responsible for any properties, decisions on property strategies could impact on our services.

An HSCP Joint Capital Planning Group had been established and the development of a draft Property Strategy had been a key strand of work which, once approved, would inform the work of the group going forward.

DECIDED:

(a) That the Renfrewshire IJB Property Strategy, which formed the appendix to the report be approved; and

(b) That the Chief Officer submit a report to the next meeting of the IJB relative to the implementation of the Property Strategy.
Report by Chief Officer.
14
Under reference to item 13 of the Minute of the meeting of this IJB held on 23 June 2017 the Chief Officer submitted a report outlining the preparation underway for the joint inspection of adult services.

The report intimated that HSCP’s position statement was due for submission by 23 October 2017 and the fieldwork would commence on 13 November 2017.  The draft inspection report was expected in early February 2018.

DECIDED: That the report be noted.
Report by Chief Officer.
15

The Chief Officer submitted a report providing an update on the range and provisions to be delivered under The Carers (Scotland) Act which would commence on 1 April 2018.

The report intimated that the Act related to both adult and young carers and provided information in relation to local governance arrangements and implementation approach; assessment of Renfrewshire HSCP and Renfrewshire Council’s readiness for the introduction of the Act; the timeline for approval of local eligibility criteria; and management of the key risks identified.

DECIDED:

(a) That the report be noted; and

(b) That a report be submitted to the next meeting of the IJB providing an update on Renfrewshire’s position in terms of the readiness against the key provisions required in advance of the Act’s implementation on 1 April 2018.

Report by Clerk.
16
Under reference to item 17 of the Minute of the meeting of the IJB held on 23 June 2017 the Clerk submitted a report relative to proposed dates of meetings of the IJB in 2017/18.

DECIDED: 

(a) That meetings of the IJB be held at 10.00 am on 24 November 2017, 26 January and 29 June 2018 and at 9.30 am on 23 March 2018; and

(b) That meetings of the IJB be held in the Abercorn Conference Centre, Renfrew Road, Paisley unless that venue is unavailable or unsuitable, in which case it be delegated to the Clerk and Chief Officer, in consultation with the Chair and Vice Chair, to determine an alternative venue.

Supplementary Agenda

Agenda
Notification
To Follow Item

I refer to the agenda for the meeting of the Integration Joint Board to be held on 15 September 2017 at 10.00 am and enclose the undernoted reports relative to items 7, 8 and 12 of the agenda.

 

The report in relation to item 7 was not enclosed with the agenda and the reports in relation to items 8 and 12 were previously marked 'to follow'.

Committee Members
Standard Items

Attendance

Name
12
 Page 2 of 2, items 26 to 26 of 26.
David Wylie
Name
No other member attendance information has been recorded for the meeting.
NameReason for Sending ApologySubstituted By
Ms Dorothy McErlean  

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