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.

Councillor Jennifer Adam-McGregor (Renfrewshire Council); Ann Cameron Burns (Greater Glasgow & Clyde Health Board); Karen Jarvis (Registered Nurse); Stephen Cruickshank (service user residing in Renfrewshire) and John Trainer, Chief Social Work Officer (Renfrewshire Council).

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

The Minute of the meeting of the Integration Joint Board (IJB) held on 28 January 2022 was submitted.

DECIDED: That the Minute be approved.

The Clerk submitted a report relative to the appointment of the Clerk and Standards Officer for the IJB.

The report intimated that Ken Graham retired from Renfrewshire Council on 28 February 2022 and that as Head of Corporate Governance, Renfrewshire Council, Ken was Clerk to the IJB. Mark Conaghan had been appointed as Head of Corporate Governance, Renfrewshire Council, with effect from 1 March 2022 and would be Clerk to the IJB as of that date.

The report advised that, at the meeting of the IJB held on 18 March 2016, the IJB considered a report providing an update on the integration of health and social care services in Renfrewshire. At this meeting it was noted that the Standards Commission of Scotland had issued an advice note on the requirement for all devolved public bodies to appoint a Standards Officer. The report proposed that Renfrewshire Council’s Head of Corporate Governance be appointed to the role of Standards Officer for the IJB, and this was agreed. This appointment required to be approved by the Standards Commission and on 25 April 2016, the Standards Commission of Scotland advised that they approved the appointment of Ken, and his equivalent successors, to the role of Standards Officer for the IJB. In terms of this approval, Mark Conaghan, as Head of Corporate Governance, will be the Standards Officer for the Joint Board with effect from 1 March 2022.

DECIDED:

(a) That it be noted that Mark Conaghan would be Clerk to the IJB with effect from 1 March 2022; and

(b) That it be noted that Mark Conaghan, as Head of Corporate Governance, would be the Standards Officer for the IJB with effect from 1 March 2022.

Under reference to item 2 of the Minute of the meeting of the IJB held on 28 January 2022, the Clerk submitted a report relative to the extended appointment of Christine Laverty as Interim Chief Officer for a further period until the permanent Chief Officer has been appointed.

The report intimated that the substantive recruitment process had now commenced and that the post would be advertised this month. 

The report advised that the chief executives of Greater Glasgow and Clyde Health Board and Renfrewshire Council had agreed to extend Christine Laverty’s appointment as Interim Chief Officer from 31 March 2022 until the permanent Chief Officer had been appointed. This extended appointment required to be ratified by the IJB and as such it be noted that Christine would continue to be a member of the IJB until that date.

DECIDED: That the extended appointment of Christine Laverty as Interim Chief Officer be ratified and that it be noted that Christine would continue to be a member of the Integration Joint Board until the permanent Chief Officer had been appointed.

Under reference to item 3 of the Minute of the meeting of the IJB held on 28 January 2022, the Clerk submitted a report providing an update on the membership of the IJB.

The report intimated that the NHS Board had advised that it had been unable to source a replacement for Dr Shilpa Shivaprasad due to staffing pressures across the medical workforce. The IJB would be advised of Dr Shivaprasad’s replacement once known.

The report advised that Diane Young had resigned from her position with NHSGGC and the appointing body had advised that Diane would be replaced by Paul Higgins, Service Manager for Podiatry, with effect from 1 April 2022, for a period of three years. Further, that Paul would also replace Diane as a non-voting member of the IJB Audit, Risk and Scrutiny Committee with effect from 1 April 2022.

At the meeting of the IJB held on 28 June 2019, it was noted that Margaret Kerr had been appointed as a non-executive director of NHSGGC Health Board and, as such, replaced Morag Brown in the position of voting member of Renfrewshire IJB, effective from 1 April 2019. Margaret’s appointment as a non-executive director of the Health Board was for a period of four-years until 31 March 2023. The Integration Scheme stated that voting members of the IJB shall be appointed for a maximum period of three years and that, if the IJB deemed it appropriate, a voting member may be reappointed. In terms of the decision taken by the IJB on 28 June 2019, Margaret’s continued membership as a voting member of the IJB until 31 March 2023 required to be confirmed by the IJB.

DECIDED:

(a) That it be noted that the NHS Board had intimated that it had been unable to source a replacement for Dr Shilpa Shivaprasad due to staffing pressures across the medical workforce and that the IJB would be advised of Dr Shivaprasad’s replacement once known;

(b) That the IJB confirm that Paul Higgins be appointed as a non-voting member to the IJB, with effect from 1 April 2022, for a period of three years;

(c) That the IJB confirm that Paul Higgins be appointed as a non-voting member to the IJB Audit, Risk and Scrutiny Committee, with effect from 1 April 2022; and

(d) That the IJB confirm that Margaret Kerr continue to be a voting member of the IJB until 31 March 2023.

The Chair of the IJB Audit, Risk and Scrutiny Committee referred to the meeting of the IJB Audit, Risk and Scrutiny Committee held on 18 March 2022 and advised that the Committee had decided that the action in relation to HSCP Internal Care at Home Services Inspection (Update) be removed until updated information was received from the Care Inspectorate; considered Audit Scotland’s annual audit plan for 2020/21 and had a robust discussion regarding timescales; considered reports by the Assistant Chief Internal Auditor relative to  the internal audit plans for 2021/22 and 2022/23; scrutinised the risk register; and considered a health and safety update. 

DECIDED: That the verbal update be noted.

The rolling action log for the IJB was submitted.

DECIDED: That the rolling action log be noted.

Under reference to item 4 of the Minute of the meeting of the IJB held on 28 January 2022, the Clerk submitted a report relative to COVID-19 emergency governance arrangements.

The report intimated that on 14 January 2022, the IJB authorised the Interim Chief Officer, in consultation with the Chair and Vice Chair of the IJB, to make urgent decisions where necessary arising from the impact of the Omicron variant of COVID-19 that required to be taken. Further, that at the meeting of the IJB held on 28 January 2022, it was decided that this temporary delegation be further extended until the meeting of the IJB scheduled to be held on 25 March 2022. 

The report confirmed that the Interim Chief Officer had not required to invoke these delegated powers, and in light of the improving situation and changes to national direction around COVID-19, no further extension to this arrangement was sought.

DECIDED:

(a) That it be noted that the Interim Chief Officer had not been required to invoke the temporary delegated powers agreed by the IJB during 14 January and 25 March 2022; and

(b) That, in light of the improving situation, it be noted that no further extension to this arrangement was sought.

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 22 January 2022.

 

The report intimated that the impact of the pandemic continued to fluctuate, evidenced through infection rates and hospitalisation figures which had again increased in recent weeks. However, for many people the severity of the virus appeared to have significantly reduced and, in response, the Scottish Government had published an updated Strategic Framework setting out the lifting of remaining legal restrictions in line with the objective of ‘living with COVID’.

The report provided an update on operational services, including the agreement across NHSGGC for the closure of all remaining COVID Assessment Centres, reflecting reduced demand.

The report also provided detail in relation to the Scottish Government’s updated Strategic Framework; COVID and winter flu vaccination programmes; care homes; the COVID assessment centre; day support and respite; and mental health inpatient services.

The report advised that the HSCP had anticipated that this report would be the last separate COVID update report to the IJB, however, in light of the current position of increased infection rates and subsequent hospitalisations, a further update would be provided to the IJB at the next meeting to be held on 24 June 2022.

DECIDED: 

(a) That the implications of the Scottish Government’s updated Strategic Framework and its overarching objectives, as detailed in section 4 of the report, be noted; and

(b) That the updates provided on COVID services and the current impact of the pandemic on the provision of operational services, as detailed in sections 5 to 9 of the report, be noted.

The Interim Chief Officer submitted a report providing an update on operational activity and additional policy developments that the HSCP was building into future workplans.

In particular, the report provided an update on the Scottish Government’s publication of an analysis of the responses received to the National Care Service consultation undertaken in 2021 and further amendments to overall timescales for development of a Workforce Plan for 2022/25. 

In addition, the report informed on progress in wider strategic planning activity being undertaken for carers and palliative care and other Scottish Government policy developments. 

DECIDED:

(a) That the Scottish Government’s publication of an analysis of responses to the National Care Service consultation and the summary of findings, as detailed in section 4 of the report, be noted;

(b) That the update provided on Scottish Government timelines for the submission of Workforce Plans for 2022/25 and the work underway, as detailed in section 5 of the report, be noted;

(c) That the further strategy development updates on the National Carers Strategy and Renfrewshire Palliative Care Strategy, as detailed in sections 6 and 7 of the report, be noted;

(d) That the update provided on planned repairs to the Disability Resource Centre, as detailed in section 8 of the report, be noted; 

(e) That the policy developments identified, including a review of the healthcare response to winter 2021/22; the joint publication of the Coming Home Implementation Report by the Scottish Government and CoSLA; Audit Scotland’s Briefing on Alcohol and Drug Services in Scotland and an update on the national mission to reduce drug deaths; and the update on indicative funding in future years to support mental health and wellbeing services within Primary Care, as detailed in sections 9 to 13 of the report, be noted; 

(f) That the update on current numbers of registered patients and GPs currently working in Renfrewshire, as detailed in section 14 of the report, be noted; and

(g) That the key challenges and recommendations made within Audit Scotland’s review of the NHS in Scotland 2021 and the Local Government in Scotland: Financial Overview updates, as detailed in sections 15 to 16, be noted.

The Chief Finance Officer submitted a report relative to the revenue budget position as at 31 January 2022 and the projected year-end position for the year ended 31 March 2022.

The report intimated that the impact of COVID-19 on services delivered by the HSCP had been unprecedented and continued to create additional delivery and financial pressures for the HSCP as well as impacting on the HSCP’s transformation and savings plans, which were subject to ongoing review and realignment.   

The IJB year-to-date position, including the impact of COVID-19 funding, was an underspend of £1,767,000 and the projected outturn for 2021/22 was an underspend of £2,111,000. It was noted that the current projections assumed that all COVID-19 related expenditure would be fully funded by the Scottish Government. 

The report advised that the financial outlook for the IJB would be extremely challenging and that the IJB’s transformation programme would be central to the IJB achieving financial sustainability in the medium-term. Therefore, as previously agreed by the IJB and to allow time for the IJB to develop and implement its transformation programme, any underspend in 2021/22 would be used to offset expected financial pressures in 2022/23 and beyond, where and when possible. 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; other delegated services; reserves and the adult social care pay uplift.

 

 

 

 

Appendices 1 to 5 of the report detailed the revenue budget position of the HSCP, Adult Social Care, Health, and Renfrewshire Council other delegated services; 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 movement in reserves and Appendix 10 to the report detailed the vacancy position for the HSCP as at 4 February 2022.

DECIDED:

(a) That the in-year position as at 31 January 2022 be noted;

(b) That the projected year-end position for 2021/22 be noted; and

(c) That the current estimated financial assessment of the consequences of the COVID-19 pandemic for 2021/22 be noted.

The Chief Finance Officer submitted a report relative to the financial allocation and budgets made available to the IJB for 2022/23 by Renfrewshire Council and NHSGGC, outlining the main financial pressures on health and adult social care services. 

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. 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 further intimated that 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 2022/23, the Bill for which was passed on 10 February 2022, and provided an overview of the IJB’s budget allocation for 2022/23. It was noted that, as a direct and ongoing consequence of the COVID-19 pandemic, the financial year 2021/22 had presented financial challenges and complexities beyond anything previously experienced. The impact of COVID-19 on services delivered by the HSCP had been unparalleled and had required ongoing 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. The continually changing situation, along with the potential for future spikes in demand for services had and would continue to create additional delivery and financial pressures as well as impacting the HSCP’s transformation and savings plans which would require ongoing review and realignment. 

The report advised that the Scottish Government had not provided detailed spending plans beyond their draft budget for 2022/23. The Scottish Government had given a commitment for a full resource spending review in May 2022, the aim of which was to set out long-term funding plans and the roadmap for delivering key commitments, such as the National Care Service. The continuation of single-year settlements at this time was challenging for the IJB and continued the uncertainty for future medium-term financial planning, as well as that of funding partners.

A copy of the letter dated 9 December 2021 from the Director of Health Finance and Governance, Scottish Government, formed Appendix 1 to the report; a copy of the letter dated 9 March 2022 from the Director of Finance and Resources, Renfrewshire Council formed Appendix 2 to the report; and a copy of the letter dated 9 March 2022 from the Assistant Director of Finance-Financial Planning & Performance, NHSGGC formed Appendix 3 to the report.

The report highlighted that the 2022/23 budget proposals had been presented on a ‘business as usual’ basis, however, ongoing and developing COVID-19 issues continued to highlight that this was not the case and extraordinary costs were being incurred and would continue to be incurred for the foreseeable future. 

The Chief Finance Officer intimated that a further report would be submitted to the IJB if the drawdown from general reserves to cover the funding gap would exceed £341,000, as detailed in the report.

DECIDED: 

(a) That the delegated Adult Social Care Budget for 2022/23, as detailed in Appendix 2 to the report, be accepted; 

(b) That the delegated Health Budget for 2022/23, 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 for the IJB in respect of any additional and/or recurring funding; 

(c) That a drawdown of reserves be approved, if required, in order to fund any shortfall in funding for 2022/23; and 

(d) That it be noted that, as detailed in section 11 of the report, the 2022/23 budget proposals assumed ‘business as usual’. The potential ongoing financial and economic impact of COVID-19 represented a significant additional risk to the IJB and the wider public sector going forward.

The Chief Finance Officer submitted a report relative to the Medium-term Financial Plan 2022/25, a copy of which was appended to the report.

The report intimated that the Plan outlined the financial challenges and opportunities the HSCP faced over the next three years and provided a framework which would support the HSCP to remain financially sustainable. The Plan would also complement the HSCP’s new Strategic Plan, highlighting how the HSCP medium-term financial planning principles would support the delivery of the IJB’s objectives and priorities. 

 

 

 

 

The report provided detail on the medium-term financial outlook; the projected budget gap; the financial challenge; responding to the local financial challenge; the medium-term financial strategy; and reserves. The Chief Officer and Chief Finance Officer would work with IJB members to take forward the Medium-term Financial Strategy to deliver financial balance whilst delivering safe and sustainable services.

DECIDED:

(a) That the assumptions and context of the financial plan for 2022/23 to 2024/25 and the levels of uncertainty that existed in relation to a range of these assumptions be noted; and

(b) That the Medium-term Financial Plan 2022/23 to 2024/25 be approved.

Under reference to item 7 of the Minute of the meeting of the IJB held on 19 November 2021, the Head of Strategic Planning and Health Improvement submitted a report relative to the IJB’s Strategic Plan 2022/25, a copy of which was appended to the report. 

The report intimated that consultation on the draft IJB Strategic Plan 2022/25 was undertaken during December 2021 and January 2022 and this report provided an overview of the feedback received and, where appropriate, had been reflected in the final version of the Plan. 

The report set out the next steps which would be focussed on the finalisation of annual development plans for each care planning group, and which would set out actions to be taken in Year 1 of the Plan in alignment with the agreed strategic objectives. These actions would be linked to existing performance indicators where possible and additional measures would be identified to enable progress to be tracked and reported to the IJB through existing performance management processes.

It was noted that the final version of the Plan would be published and shared with partner organisations and that the online and easy-read versions would also be updated to reflect the changes that had been made.

Members thanked the Head of Strategic Planning and Health Improvement and her team for the work undertaken during the consultation process and drafting of the final Plan. It was noted that carers felt listened-to, valued and very much included in the process and that this was appreciated.

DECIDED:

(a) That the final version of the Strategic Plan 2022/25; and

(b) That the next steps outlined regarding the creation of a Strategic Delivery Plan, which would be brought to the IJB in June 2022 for approval, be noted.

The Head of Strategic Planning and Health Improvement submitted a report providing an update on the HSCP and Ministerial Strategic Group (MSG) unscheduled care indicators.

The report intimated that progress on unscheduled care performance measures during 2021/22 was monitored as part of the HSCP overall performance management process. The report provided detail in relation to delayed discharges at census point (18+); bed days lost to delayed discharge (18+); the number of emergency admissions (18+); the number of unscheduled hospital bed days, acute specialities (18+); and A&E attendances (18+).

DECIDED: That Renfrewshire HSCP’s unscheduled care performance be noted.

Under reference to item 11 of the Minute of the meeting of the IJB held on 17 September 2021, the Head of Health and Social Care submitted a report presenting the Design and Delivery Plan as the updated and refreshed Board-wide Strategic Commissioning Plan for Unscheduled Care, a copy of which formed Appendix 1 to the report. The Financial Framework formed Appendix 2 to the report.

The report intimated that at its meeting held on 17 September 2021, the IJB considered a report on the Board-wide draft Unscheduled Care Commissioning Plan which was subsequently agreed by the other five HSCPs in NHSGGC. Since then, comments had been received on the draft progress made on a number of key actions and, in addition, the Scottish Government had allocated winter planning monies which were agreed at the meeting of the IJB held on 28 January 2022, and it was noted that the financial framework had been updated to reflect this.

The report presented the updated unscheduled care programme in the form of the final Design and Delivery Plan for the period 2022/23 to 2024/25 and it was noted that similar reports were being considered by the other five HSCPs in NHSGGC and the Health Board.

DECIDED:

(a) That the Design and Delivery Plan 2022/23 to 2024/25, which formed Appendix 1 to the report, be approved as the updated and refreshed Board-wide unscheduled care improvement programme;

(b) That the Financial Framework, outlined in section 6 of the Plan, and which formed Appendix 2 to the report, be approved; 

(c) That the performance management arrangements to report on and monitor progress towards delivery of the Plan be noted; 

(d) That it be noted that a further update on the delivery of the programme would be considered towards the end of 2022/23; and

(e) That it be noted that the Plan would be reported to all six IJBs simultaneously and also separately to the NHSGGC Board’s Finance, Audit and Performance Committee.

The Clerk submitted a report relative to proposed dates of meetings of the IJB in 2022/23.

The report intimated that the next scheduled meeting of the IJB would be held at 10.00 am on 24 June 2022 and the report proposed that this meeting be held remotely using MS teams.

The suggested dates and times for future meetings were detailed in the report and it was noted that a further report would be submitted to the next meeting of the IJB scheduled to be held on 24 June 2022 in relation to arrangements for future meetings.

DECIDED:

(a) That it be noted that the next meeting of the IJB would be held at 10.00 am on 24 June 2022;

(b) That this meeting be held remotely using MS teams;

(c) That meetings of the IJB be held at 10.00 am on 16 September and 25 November 2022, and 27 January, 31 March and 30 June 2023; and

(d) That it be noted that a further report would be submitted to the IJB meeting on 24 June 2022 in relation to arrangements for future meetings.

DECIDED: That it be noted that the next meeting of the IJB would be held at 10.00 am on 24 June 2022.