Councillor Jacqueline Cameron, Councillor Lisa-Marie Hughes, Councillor Michelle Campbell (substitute for Councillor Jennifer Adam-McGregor) and Councillor Jane Strang (substitute for Councillor Scott Kerr) (all Renfrewshire Council); Dr Donny Lyons, Morag Brown, Dr Linda de Caestecker and Dorothy McErlean (all Greater Glasgow & Clyde Health Board); Graham Capstick (Trade Union representative for Health Board); John Boylan (Trade Union representative for Council); Karen Jarvis (Registered Nurse); Helen McAleer (unpaid carer residing in Renfrewshire); 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).

Dr Donny Lyons, Chair, presided.

Ken Graham, Head of Corporate Governance (Clerk) and Carol MacDonald, 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, Fiona Mackay, Head of Strategic Planning & Health Improvement and Jean Still, Head of Administration (all Renfrewshire Health and Social Care Partnership).

Councillor Campbell declared an interest as she was a member of staff for NHS Greater Glasgow and Clyde.  However, as she considered the interest to be insignificant in terms of the Code of Conduct and that she was not conflicted by any items on the agenda, she did not consider it necessary to leave the meeting.

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 6 of the agenda after item 1 of the agenda.

The Chief Officer submitted a report relative to the Renfrewshire Community Plan 2017/27, a copy of which formed the appendix to the report.

The Plan set out the key priorities for Renfrewshire which would be targeted by community planning partners with local communities over a 10-year period.  Renfrewshire HSCP was a key community planning partner and played an active role in working in partnership to deliver the outcomes of the Plan.

It was proposed that the first recommendation contained within the report be changed to ‘approve’ rather than ‘note’ as the HSCP and NHSGG&C were community planning partners.  This was agreed.

DECIDED:

(a) That the Renfrewshire Community Plan 2017/27, approved by Renfrewshire Council on 28 September 2017, be approved; and

(b) That it be noted that updates would be brought back to the IJB to keep members sighted on progress of delivery against the measures contained within the Plan.

Councillor Jennifer Adam-McGregor and Councillor Scott Kerr (both Renfrewshire Council); Stephen Cruickshank (service user residing in Renfrewshire) and Alan McNiven (third sector representative).

The Minute of meeting of the Integration Joint Board (IJB) held on 15 September 2017 was submitted.  

DECIDED: That the Minute be approved.

The Chief Finance Officer submitted a report relative to the revenue and capital budget positions from 1 April to 15 September 2017 for Social Work and from 1 April to 30 September 2017 for the Health Board, as detailed in appendices 1 and 2 to the report.  

The report provided an update on the implementation of the Living Wage for 2017/18.

The overall revenue position for the HSCP at 30 September 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.

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 Renfrewshire 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; and Appendix 6 to the report detailed the reserve balances as at 30 September 2017.

Discussion took place on the increase in specialist observation costs and what was being done to address the situation; concern was also raised that savings were linked to staff vacancies and that the living wage was not being implemented.  It was proposed that an update report would be submitted to a future meeting of the Board relative to the on-going issues.  This was agreed.

DECIDED: 

(a) That the current revenue budget position as at 30 September 2017 be noted;

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

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

(d) That it be agreed that an update report would be submitted to a future meeting of the Board relative to the on-going issues.

Under reference to item 5 of the Minute of the meeting of the IJB held on 15 September 2017 the Chief Finance Officer submitted a report relative to a revised Renfrewshire Integration Joint Board Reserves Policy, a copy of which formed the appendix to the report.

The report intimated that the Reserves Policy had been revised to provide clarity on the level of reserves which could be held by the IJB, including ear-marked reserves.  Section 6.2 of the Reserves Policy had been revised to reflect that the level of ear-marked reserves which could be held was in addition to general reserves; sections 7 and 8 had also been updated to reflect current practice and work required as part of the annual accounts process.

DECIDED: That the revised Renfrewshire Integration Joint Board Reserves Policy, which formed the appendix to the report, be approved.

The Chief Officer submitted a report relative to the performance management report for April to September 2017.

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

There were 91 performance indicators of which 45 had targets set against them.  Performance status was assessed as red if more than 10% variance from target; amber if within 10% variance of target; or green if on or above target.  The dashboard indicated that currently 22% of performance measures had red status, 18% had amber status and 60% had green status.

Discussion took place on the performance outcomes that fell below target and specifically the GP Incentivised Scheme and the Anticipatory Care Plans.  It was proposed that a report be submitted to a future meeting of the Board relative to the on-going issues.  This was agreed.

DECIDED:

(a) That the Performance Management Mid-Year Report 2017/18 for Renfrewshire HSCP be approved; and

(b) That it be agreed that a report be submitted to a future meeting of the Board relative to the on-going issues.

Under reference to item 11 of the Minute of the meeting of the IJB held on 23 June 2017 the Chief Officer submitted a report seeking members continued support for the evolving Change and Improvement Programme including approval of a number of savings and efficiencies.

The report intimated that the Change and Improvement Programme was being delivered through three workstreams and Appendix 1 to the report provided an overview of the supporting projects which were being delivered by each workstream and progress to date.

Section 6 of the report detailed the first phase of savings identified through ongoing change and improvement work.  The proposed savings had been assessed by the Finance and Planning Forum to ensure they aligned with strategic and financial plans and were deliverable and viable within the next three years.  The Professional Advisory Group had also reviewed and risk assessed each proposal to provide an independent view on whether they could be delivered safely and in line with agreed clinical, quality and care standards and had identified mitigation where risks had been highlighted.

It was noted that the trade unions had not had sight of the reviews of the staffing structure and any changes in respect of local authority workers required communication with the Trade Unions.  

It was proposed that the following information be submitted to a future meeting of the Board: (i)  that more detail be proved relative to the further savings to be realised to the Mental Health & Addictions Service; and (ii) that further information be provided on how the Professional Advisory Group were involved and the process they used to conclude their investigation.  This was agreed.

DECIDED: 

(a) That the scope and progress of the 2017/18 Change and Improvement Programme to date be noted;

(b) That the saving proposals set out in section 6 of the report be approved;

(c) That it be noted that regular updates would be brought to the IJB to report on programme progress and seek approval for any new change and improvement work, including further savings proposals identified, to be included within this evolving programme;

(d) That it be noted that any change to the staffing structure in respect of local authority workers required communication with the Trade Unions; and

(e) That it be agreed that a report be submitted to a future meeting of the Board which detailed how the savings to the Mental Health & Addictions Service were to be realised and more detailed information on how the Professional Advisory Group were involved in the financial planning process and the methods they used to conclude their investigation.

Under reference to item 3 of the Minute of the meeting of the IJB held on 15 September 2017 the Chief Officer submitted a report providing an update on the day care 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 although Capability Scotland had re-stated their intention to cease provision of this service, further agreement had now been reached to extend the timescale until 30 April 2017 to allow further time to plan the transition arrangements for each of the 47 service users.  This had been communicated to all service users and their respective families on 10 October 2017.

Staff from Renfrewshire Learning Disability Service and the locality team, supported by Capability Scotland staff and You First Advocacy, had met with 43 service users/families to discuss service user preferences; initial liaison work had taken place with the community link team within Renfrewshire HSCP to map out and identify whether mainstream community opportunities would be appropriate for some of the service users; initial discussions had taken place with Capability Scotland regarding an alternative service model in Renfrewshire and an outline plan had been submitted to the Chief Officer; and a market testing exercise took place on 23 October 2017 with a number of third-sector organisations to gauge interest in taking over the two day services.

It was noted that the next steps included progressing discussions with all service users and family members/carers regarding assessed needs, SDS budgets, individual preferences and progressing clear individual care plans based on agreed service choices; progressing plans to extend the community networks service and working with Capability Scotland to consider their proposed community service model; and progressing the market testing process with any provider interested in taking on the existing service.

 

It was proposed that a project plan detailing a timeline be submitted to the next meeting of the IJB to be held on 26 January 2018 and, if possible, the information shared with members prior to the meeting and that cognisance be taken of involving service users, carers and trade unions in the process going forward.  This was agreed.

DECIDED:

(a) That the current position regarding Capability Scotland, as detailed in section 4 of the report, be noted;

(b) That the planned next steps, as detailed in section 5 of the report, be noted;

(c) That a project plan detailing a timeline be submitted to the next meeting of the IJB to be held on 26 January 2018 and, if possible, the information shared with members prior to the meeting; and

(d) That cognisance be taken of involving service users, carers and trade unions in the process going forward.

Under reference to item 15 of the Minute of the meeting of the IJB held on 15 September 2017 the Chief Officer submitted a report relative to preparation for implementation of The Carers (Scotland) Act 2016 which would come into force on 1 April 2018.

The report provided information in relation to Renfrewshire’s position in terms of readiness against the key provisions required by the Act; the formal consultation process on the draft local Eligibility Criteria for young carers and adult carers which was currently underway; Scottish Government funding to support preparations for the Act over the coming year and beyond; and an update on the management of key risks identified by the Carers Act Strategic Steering Group.

DECIDED: 

(a) That the report be noted; and

(b) That a report be submitted to the next meeting of the IJB to be held on 26 January 2018 on the findings of the consultation; seeking approval of the final drafts of the Adult and Children’s Eligibilty Criteria, and providing a further update on Renfrewshire’s readiness for the Act’s implementation on 1 April 2018.

The Chief Social Work Officer (CSWO) submitted a report relative to his annual report which he had submitted to the meeting of Renfrewshire Council held on 28 September 2017.  The Public Bodies (Joint Working) Scotland Act 2014 established the CSWO as part of the HSCP governance structure in order to carry out those statutory duties in relation to social work services provided by those partnerships.  

The Council’s Director of Children’s Services, in his role as CSWO, provided an overview of the report, referred to the role and key areas of activities of the CSWO locally and outlined the issues and challenges encountered during 2016/17.  The report provided information in relation to local governance arrangements; the activities of the CSWO; an overview of activities within social work service and key priorities in 2017/18.    

DECIDED: 

(a) That the key activities outlined within the report be noted; 
  
(b) That it be noted that the annual report would be submitted to the Office of the Chief Social Work Officer at the Scottish Government; and 
  
(c) That it be agreed that annual reports would continue to be provided to the IJB.

The Chief Officer submitted a report relative to the work being carried out by NHSGG&C to develop a Transformation Strategy for NHS services within the Health Board area.  A copy of the NHSGG&C transformation plan Moving Forward Together formed the appendix to the report.

DECIDED:

(a) That the report be noted;

(b) That ongoing involvement of officers from the HSCP to develop the Moving Forward Together Strategy be agreed; and

(c) That authority be delegated to the Chief Officer to identify an appropriate member(s) to represent the IJB and HSCP on the Stakeholder Reference Group.

The Chief Officer submitted a report relative to the challenges faced by the Care at Home Service and outlining the work currently underway through a review of the service to mitigate risk and to continue to develop the service to be fit for the future.

The review aimed to support the three-year transformational programme already underway within the service, which sought to modernise and improve the service to enable it to respond to increasing demands, growing complexity of needs and ensure the service worked as efficiently and effectively as possible; and to examine service systems, processes and practice to identify service pressures and to determine root causes of any challenges and concerns which impacted on delivery of Care and Home Services.

DECIDED: That the report and the work underway through the review process be noted.

The Chief Officer submitted a report relative to the Climate Change (Duties of Public Bodies: Reporting Requirements) (Scotland) Order 2015.

The report intimated that the Order came into force in November 2015 as secondary legislation made under the Climate Change (Scotland) Act 2009 and required bodies, including the IJB, to prepare reports on compliance with climate change duties. 

The Renfrewshire Integration Joint Board Climate Change Report 2016/17, which formed the appendix to the report, would be submitted to Sustainable Scotland Network.

DECIDED:

(a) That the report be noted: and

(b) That the Renfrewshire Integration Joint Board Climate Change Report 2016/17, as detailed in the appendix to the report, be approved for submission to Sustainable Scotland Network.

DECIDED: That it be noted that the next meeting of the IJB would be held at 10.00 am on 26 January 2018 in the Abercorn Conference Centre.