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Meeting Details

Renfrewshire Health and Social Care Integration Joint Board.
26 Mar 2021 - 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: Shiona Strachan: Sarah Lavers: John Trainer.

 

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

 
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.

Councillor Jennifer Adam-McGregor (Renfrewshire Council); Frank Shennan (Greater Glasgow & Clyde Health Board); Karen Jarvis (Registered Nurse); Diane Young (Health Board staff member involved in service provision); and Stephen Cruickshank (service user residing in Renfrewshire).

 

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.

Councillor Campbell declared an interest as she was an employee of NHS Greater Glasgow & Clyde but not in the Renfrewshire IJB area. 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.

 

1 Minute
Minute of meeting of the Integration Joint Board (IJB) held on 29 January 2021.
1
The Minute of the meeting of the Integration Joint Board (IJB) held on 29 January 2021 was submitted.

DECIDED: That the Minute be approved.
IJB 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 Interim Chief Officer.
3
The Interim Chief Officer submitted a report providing an update on key operational activity, including the HSCP’s operational response to COVID-19, since the last meeting of the IJB held on 29 January 2021.

The report intimated that the continually changing circumstances locally and nationally continued to necessitate the prioritisation of the HSCP’s response to the pandemic, including the continued delivery with partners of the COVID-19 vaccination programme. The report also provided an update on the regional and national developments for health and social care services.

The report provided detail in relation to the COVID vaccination programme; care homes; updated care home visiting guidance; the care home testing team; PPE and lateral flow testing; the COVID assessment centre; operational service updates; the NHSGGC remobilisation plan; the national reporting arrangements for Integration Schemes, Strategic Commissioning Plans and Annual Performance Reviews; workforce planning; the Renfrewshire HSCP Expenses Policy for Unpaid Carers; NHS national whistleblowing standards; Audit Scotland’s report: The NHS in Scotland 2020; and preventing homelessness in Scotland Recommendations: Impact on HSCPs.

DECIDED: 

(a) That the updates on the COVID vaccination programme, ongoing operational response to the COVID pandemic, and NHSGGC remobilisation plans, as detailed in sections 4 to 11 of the report, be noted;

(b) That the update from the Scottish Government on reporting requirements for Annual Performance Reports, Integration Scheme reviews and the development of Strategic Plans, as detailed in section 12 of the report, be noted;

(c) That it be noted that work had commenced on the Annual Performance Report for 2020/21 and that a Strategic Plan proposal would be brought to the IJB in June 2021, as detailed in section 12 of the report;

(d) That the additional HSCP strategy and planning updates provided on the development of a one-year workforce plan for 2021/22 and the draft expenses policy for unpaid carers, as detailed in sections 13 to 14 of the report, be noted;

(e) That the updates provided on developments in national policy and strategy, covering the implementation of national whistleblowing standards within the NHS, Audit Scotland’s report on the NHS in Scotland 2020 and the Scotland Prevention Review Group’s recommendations for preventing homelessness, as detailed in sections 15 to 17 of the report, be noted; and

(f) That the draft expenses policy for unpaid carers, as detailed in section 14 and Appendix 1 of the report, be noted.
Report by Chief Finance Officer.
4
The Chief Finance Officer submitted a report relative to the revenue budget position at 31 January 2021 and the projected year-end position for the year ended 31 March 2021.

The report intimated that as previously 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. These impacts were likely to continue over the medium-term and at least over the next few financial years. The continually changing situation, potential for future spikes in demand for services would create additional delivery and financial pressures as well as impacting on the HSCP’s transformation and savings plans, which would require 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 costs 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, including the impact of COVID funding for the first quarter of 2021/22, was an underspend of £9,425,000 and the projected outturn for 2021/22 was an underspend of £11,184,000. The IJB year-to-date position, net of COVID-19 and including the assumption that ring-fenced balances would be transferred to earmarked reserves at the financial year end, was a year-to-date underspend of £4,720,000 and the projected outturn for 2020/21 was an underspend of £5,624,000. The key pressures were highlighted in section 4 of the report.

The report provided information on responding to the COVID-19 pandemic; the current vacancy position; Scottish Government Funding 2020/21; reserves; proposed increases to earmarked reserves; and a summary of the 2020/21 Scottish Living Wage.

Appendices 1 to 5 of the report detailed the revenue budget position of the HSCP   and Adult Social Care  the period 1 April 2020 to 5 February 2021 and the year-end position, for Health for the period 1 April 2020 to 31 January 2021 and the year-end position and for ‘other delegated services’ for the period 1 April to 5 February 2021; Appendices 6 and 7 to the report provided a reconciliation of the main budget adjustments applied this current financial year; Appendix 8 to the report detailed the Scottish Government funding streams; Appendix 9 to the report detailed the HSCP funded earmarked reserves; Appendix 10 to the report detailed the vacancy position for the HSCP as at 5 February 2021 by client group and job description; Appendix 11 to the report provided a summary of the recurring and non-recurring costs associated with delivering the transfer of analogue phone lines to digital; and Appendices 12 to 16 to the report provided detail of Scottish Government ring-fenced funding for a number of Scottish Government priority areas.

The Chief Finance Officer advised that the Scottish Government had agreed a universal 2.2% uplift on the unit cost to payments to providers in respect of the Scottish living wage uplift for 2021/22 and that additional funding was being made available as part of the 2021/22 budget settlement.

DECIDED:

(a) That the in-year position as at 31 January 2021 be noted;

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

(c) That the current estimated financial assessment of the consequences of the COVID-19 pandemic for 2020/21 be noted; and 

(d) That the increases to earmarked reserves, as detailed in paragraph 9.6 of the report, which included advance funding allocated by the Scottish Government for a number of Scottish Government priority areas including COVID-19 related costs for 2021/22, be approved; and

(e) That the future recurring pressure of £310,000 in respect of the transfer of analogue phone lines to digital, as detailed in paragraph 9.6.2.3 of the report, be noted. 
Report by Interim Chief Officer.
5
The Interim Chief Officer submitted a report providing an update on Renfrewshire HSCP’s financial planning approach for 2021/22.

The report set out proposals for savings to address short-term financial pressures and provided an update on medium-term transformation which would support financial sustainability. This approach was incorporated within the IJB’s Medium-term Financial Plan (MTFP) approved by the IJB in November 2019.

The report intimated that the MTFP for 2020/21 to 2025/26 set out the current assumptions and projected funding gap for the IJB over the next five-years, including a range of potential outcomes based on potential future funding scenarios. It also set out the IJB’s two-tiered model for delivering the MTFP by addressing short-term financial pressures whilst in parallel introducing a more strategic approach, focussing on the financial sustainability of the organisation in the medium-term. Both the MTFP and the two-tiered model were developed prior to the COVID-19 pandemic. It was noted that as a direct consequence of the pandemic, the progression of the transformation programme had been severely disrupted, with the focus of the HSCP’s activity shifting to emergency response in March 2020, significantly hampering the move ahead with Tier 2 activity. 

The report advised that the proposals in the report aimed to contribute to addressing the 2021/22 financial pressures faced by the IJB and to ensure that the IJB could meet its requirement to deliver financial balance. The savings identified for this year were of a smaller scale than would normally have been anticipated and proposed by the HSCP but reflected both the need to pause transformational saving in March 2020 and the HSCP’s ongoing focus on responding to COVID-19 across all service areas. However, it was expected that this would place greater pressure on future year savings targets, reinforcing the requirement to progress transformative activity and to carefully utilise unallocated reserves to balance the annual revenue budget position each year over the medium-term.

DECIDED:

(a) That the content of the report be noted;

(b) That the savings proposals, set out in section 8 of the report, be approved; and

(c) That it be noted that regular updates would continue to be brought to the IJB to report on financial planning and the development and evolution of the HSCP’s approach to recovery and transformation.
Report by Chief Finance Officer.
6
The Chief Finance Officer submitted a report relative to the financial allocation and budgets made available to the IJB for 2021/22 by Renfrewshire Council and NHSGGC, outlining the main financial pressures on health and adult social care services.

The Chief Finance Office updated members on the changes to the public sector pay policy for both local government and NHS employees since her report had been published and advised that this did not substantially change the IJB budget for next year as it was built on medium-term case scenarios, as highlighted in the report.

The report intimated that Renfrewshire IJB was a legal entity created by Parliamentary Order following ministerial approval of the Integration Scheme between Renfrewshire Council and NHSGGC. It was accountable for the stewardship of public funds and ensuring that its business was conducted under public sector best practice governance arrangements, including ensuring 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.

Under the 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, Chief Finance Officer, for the IJB included both the adherence to professional standards as well as compliance with The Local Government (Scotland) Act 1973 and for the IJB this included the requirement to ensure a balance budget was set.

The report set out the implications of the Scottish Government budget for 2021/22, approved on 9 March 2021, and provided an overview of the IJB’s budget allocation for 2021/22.

It was noted that the impact of COVID-19 on services delivered by Renfrewshire HSCP had been unprecedented and had required a significant degree of service change within a short period of time, ultimately having a substantial financial impact, which was likely to continue over the medium-term and at least over the next few financial years. Members would be required to take these very exceptional circumstances into account when setting the 2021/22 budget, recognising that the IJB’s immediate and medium-term priorities had changed considerably over the last 12 months.

The report advised that the Scottish Government had not provided detailed spending plans beyond their draft budget for 2021/22 but had outlined its ongoing priorities within its annual Medium-term Financial Strategy, in particular, continued focus on the NHS. The Scottish Government’s high-level forecast for the future remained uncertain, reflecting the unparalleled fall in economic output at both Scottish and UK level and uncertainty over economic recovery for both Scotland and the UK. In addition, the UK Government’s approach to economic and fiscal recovery would have a significant impact on medium to longer-term public sector spending across the UK.

The Chief Finance Officer intimated that for 2021/22, the adult social care budget offer was £74,358,164 million and the health budget offer was £233,543 million, subject to final adjustments when the out-turn for the 2020/21 financial year had been finalised.

A copy of the letter dated 28 January 2021 from the Interim Director of Health Finance and Governance, Scottish Government, formed Appendix 1 to the report; a copy of the letter dated 4 March 2021 from the Director of Finance and Resources, Renfrewshire Council formed Appendix 2 to the report; and a copy of the letter from the Assistant Director of Finance, NHSGGC formed Appendix 3 to the report; 

The report highlighted that the 2021/22 budget proposals had been presented on a ‘business as usual’ basis, however, ongoing and developing COVID-19 issues highlighted that this was not the case and extraordinary costs were being incurred and would continue to be incurred for the foreseeable future. For accounting purposes, those costs would be recorded separately, with the assumption that the costs would be covered by partners and ultimately by government.

DECIDED:

(a) That the delegated Adult Social Care Budget for 2021/22, as detailed in Appendix 2 to the report, be accepted;

(b) That the delegated Health Budget for 2021/22, as detailed in Appendix 3 to the report, be accepted subject to any final 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 2021/22 pay award; 

(c) That a drawdown of reserves be approved, if required, in order to fund any shortfall in funding for 2021/22; 

(d) That an increase to the IJB’s unallocated reserves into 2021/22 be approved through the appropriate utilisation of permitted financial flexibilities, in order to protect the financial resilience of the IJB in the context of an increased financial risk profile; and 

(e) That it be noted that, as detailed in section 11 of this report, the 2021/22 budget proposals assumed ‘business as usual’. The potential financial and economic impact of COVID-19 represented a significant additional risk to the IJB and the wider public sector going forward.
Report by Interim Chief Officer.
7
The Interim Chief Officer submitted a report providing updates on the progress of the NHSGGC Draft Unscheduled Care Joint Commissioning Plan; implementation of the new GGC-wide Discharge to Assess Policy; Renfrewshire HSCP’s Ministerial Steering Group unscheduled care indicators; the planned review of Renfrewshire HSCP’s Performance Management Framework; and the Annual Performance Report 2020/21.

DECIDED:

(a) That the progress on the NHSGGC draft Unscheduled Care Joint Commissioning Plan and Discharge to Assess Policy be noted; 

(b) That Renfrewshire HSCP’s unscheduled care performance be noted;

(c) That the proposed update/review of the HSCP’s Performance Management Framework 2021/22 be noted and that it be noted that updates would be brought to future meetings; and

(d) That the update on the Annual Performance Report 2021/22 be noted.
Report by Interim Chief Officer.
8
The Interim Chief Officer submitted a report providing an update on the publication of the report and recommendations from the independent review of adult social care in Scotland which had been published on 3 February 2021. 

The report intimated that in September 2020, the Scottish Government announced that it intended to commission an independent review of adult social care in Scotland. The review had been chaired by Derek Feeley, a former Scottish Government Director General for Health and Social Care and Chief Executive of NHS Scotland, supported by a small advisory panel of Scottish and international experts. 

The report provided a summary of the key recommendations which had emerged, highlighting those which could have an impact on the IJB, should they be taken forward.

It was noted that on 16 February 2021, the Cabinet Minister for Health and Sport had confirmed that the Scottish Government accepted the findings of the independent review and were working to make early progress on some of the recommendations. This included the creation of a £20 million Community Living Change Fund to assist in the redesign of support for people with complex needs including intellectual disabilities and autism and for people who had endured mental health problems. Further, that the Cabinet Minister had also noted that concerns had been raised by CoSLA with regards recommendations associated with the implementation of a National Care Service and that supporting discussions would continue. 

It was noted that further updates would be brought to future meetings of the IJB as further detail was provided on the recommendations made by the review. 

DECIDED: 

(a) That the recommendations arising from the independent review and those areas of possible impact on the IJB be noted; and

(b) That it be noted that further updates on the progress of the review recommendations would be brought to the IJB as further details were confirmed.
Report by Interim Chief Officer.
9
Under reference to item 8 of the Minute of the meeting of the IJB held on 29 January 2021, the Interim Chief Officer submitted a report providing a further update on the Older People’s Mental Health Strategy and further focus on adult mental health and older people mental health impatient beds.

The report intimated that the NHSGGC Adult Mental Health Strategy 2018/23 spanned across adult mental health impatient and community services to ensure services were modern, patient focussed, effective and efficient. The strategy took a whole-systems approach, linking the planning of services across NHSGGC, incorporating the planning priorities of the six HSCPs, and was aligned with delivery of the Scottish Government’s Mental Health Strategy 2017/27.

It was noted that similar reports were being considered by the other five IJBs in GGC. The next steps included further work on both the community and inpatient service models, including the commissioning implications for third and independent sector support including housing; building on learning from the response to the pandemic; developing a sustainable workforce plan that reflected the shifting balance of care and practical constraints around consultant recruitment and other recruitment challenges; progressing with Scottish Health Council and GGC community and wider stakeholder involvement and engagement on the strategy; developing an overall financial framework to support delivery of the strategies and a performance management framework. This would be done within existing budgets of £150.318 million and £38.383 million which existed for both adults and older people as detailed in appendices 1 and 2 to the report; development of proposals for the future delivery of inpatient services; and progressing forensic low secure bed developments with the Forensic Directorate and low secure adult rehabilitation at Stobhill Hospital.

DECIDED:

(a) That the report, including the financial frameworks appended to the report, be approved; and

(b) That the further work being undertaken to develop the strategies be noted with an update report being submitted to the next meeting of the IJB to be held on 25 June 2021.
Report by Interim Chief Officer.
10
The Interim Chief Officer submitted a report providing an update on the completion of the review of the IJB’s Risk Management Framework which had been last approved in November 2017. 

The report intimated that the review had considered the impact of the COVID-19 pandemic on the IJB’s risk management arrangements and ability to tolerate and effectively manage a higher degree of risk over a prolonged period; and the risk management approaches adopted by IJBs across Scotland to inform the further development of Renfrewshire IJB’s Risk Management Framework.

The report detailed the key changes to the Risk Management Framework; the updates to the IJB Risk Register; and implementation of the updated framework.

It was noted that the updated framework, which was appended to the report, had been reviewed and approved by the IJB Audit, Risk and Scrutiny Committee on 12 March 2021.

DECIDED:

(a) That the Audit, Risk and Scrutiny Committee’s decision regarding the updated Risk Management Framework be noted;

(b) That the updates that would be made to currently identified risks when the updated risk register was brought forward in June 2021 be noted; and

(c) That it be noted that this framework would be implemented from 1 April 2021 supported by the implementation actions identified in section 6 of the report.
Report by Interim Chief Officer.
11
The Interim Chief Officer submitted a report relative to an updated Records Management Plan, a copy of which was appended to the report.

The report intimated that the Records Management Plan set out how IJB records would be created and managed in line with national policy and had been developed and updated in consultation with Renfrewshire Council and NHSGGC and reflected the dependencies and linkages between the IJB’s own plan and those of partner organisations. 

It was noted that an updated version of the Records Management Plan should have been submitted to the Keeper of Records of Scotland by 29 January 2021 but the deadline date had been extended to 31 March 2021.

DECIDED:

(a) That the Records Management Plan be approved; and

(b) That the Records Management Plan be submitted to the Keeper of Records of Scotland.
Note that the next meeting of the IJB will be held at 10.00 am on 25 June 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 25 June 2021.

Declarations of Interests

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

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