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.

The Minute of the meeting of the Integration Joint Board (IJB) held on 24 June 2022 was submitted.

In relation to item 2, Councillor McMillan, requested that recommendation (d) be amended to read ‘(d) That it be noted that in line with the proposed approach to the appointment of members of the Audit, Risk and Scrutiny Committee, Councillors Jacqueline Cameron and Fiona Airlie-Nicolson had been nominated by the voting members to sit on the Audit, Risk and Scrutiny Committee (with Cllr McMillan dissenting) and that Councillor Jacqueline Cameron had been appointed as Chair of the Audit, Risk and Scrutiny Committee until September 2023.’ This was agreed.

DECIDED: That, subject to the above amendment, the Minute be approved.

The rolling action log for the IJB was submitted.

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

The Chief Officer submitted a report providing an update on key developments and operational activity since the last meeting of the IJB held on 24 June 2022 and additional policy developments which would be built into future workplans.

The report intimated that the detail within the report had been developed in the midst of significant change and uncertainty, particularly with the financial circumstances faced by the IJB and provided detail on financial planning which set out the approach being adopted by the HSCP to prepare for projected financial challenges in this and coming years and set out the context for forthcoming decisions required by the IJB. 

The report provided updates in relation to financial planning; winter planning and business continuity; workforce planning; the National Care Service; the National Records of Scotland drug, alcohol and probable suicides statistics; mental health and wellbeing in Primary Care services; the Scottish Government healthcare framework for adults living in care homes; the autumn/winter COVID-19 booster and winter vaccination programme; and the NHSGGC Primary Care support and GP out of hours services.

It was proposed that the Chief Officer issue the HSCP’s response to the consultation on the National Care Service (Scotland) Bill to members of the IJB. This was agreed.

DECIDED: 

(a) That the implications and effects of the financial planning update provided, including the approach being taken to identify savings and service development opportunities, as detailed in section 4 of the report, be noted; 

(b) That the actions being undertaken by the HSCP to ensure robust winter planning and business continuity 2022/23 arrangements were in place for the winter period, as detailed in section 5 of the report, be noted;

(c) That the workforce planning update, and in particular, the progression of actions to support international recruitment and the implementation of the HSCP’s staff development fund, as detailed in section 6 of the report, be noted;

(d) That the introduction of the draft National Care Service (Scotland) Bill and the envisaged next steps, as detailed in section 7 of the report, be noted;

(e) That the publication of statistics by the National Records of Scotland on alcohol and drug related deaths and probable deaths by suicide in Renfrewshire and Scotland in 2021 and related strategic developments, as detailed in section 8 of the report, be noted;

(f) That the update provided on mental health and wellbeing in primary services and the Scottish Government’s approval of Renfrewshire’s one year plan, as detailed in section 9 of the report, be noted;

(g) That the introduction of the Scottish Government Healthcare Framework for adults living in care homes, as detailed in section 10 of the report, be noted; 

(h) That the update on the autumn/winter COVID-19 booster and winter vaccination programme and respective timescales, as detailed in section 11 of the report, be noted; 

(i) That the update provided on hosting arrangements for NHSGGC Primary Care support and GP out of hours services, as detailed in section 12 of the report, be noted; and

(j) That the Chief Officer issue the HSCP’s response to the consultation on the National Care Service (Scotland) Bill to members of the IJB. 

The Chief Finance Officer submitted a report relative to the revenue budget position at 31 July 2022 and the projected year-end position for the year ended 31 March 2023.

The report requested that members note the key messages from the development session held on 12 August 2022 where the Chief Finance Officer highlighted the current volatility of the IJB’s budget due to the current economic and cost of living crisis and the likelihood that this would have a negative impact on projections through the financial year. The report provided further detail in paragraphs 3.4 to 3.8.

The report intimated that due to delays in receiving a number of ring-fenced allocations from the Scottish Government in respect of specific Scottish Government priorities including Act 15 and ADP, it was not clear how the in-year budget would be impacted and what conditions would be attached to the funding when it was received, including whether it would be recurring or non-recurring.

The report advised that the IJB year-to-date position, including the impact of COVID-19 which was funded from the draw-down of COVID-19 earmarked reserves, was an underspend of £753,000 and the projected outturn for 2022/23 was an underspend of £2,856,000. 

The report provided information on the key pressures; responding to the COVID-19 pandemic; Scottish Government funding 2022/23; other delegated services and reserves.

The Chief Finance Officer advised that by letter dated 12 September 2022, Richard McCallum, Director of Health, Finance and Governance, Scottish Government, advised that the Scottish Government would be clawing back the unspent HSCP’s COVID reserves and that this money would be used more widely to meet the COVID pressures around other parts of the system. Work was ongoing to identify the HSCP’s projected spend on COVID services to the end of this financial year. It was noted that the amount being returned to the Scottish Government could be in the region of £12 million and that the HSCP’s earmarked reserves would reduce significantly.

Appendices 1 to 4 of the report detailed the revenue budget position of the HSCP, adult social care, health, and Renfrewshire Council other delegated services; Appendices 5 and 6 to the report provided a reconciliation of the main budget adjustments applied this current financial year; Appendix 7 to the report detailed the Scottish Government funding streams; and Appendix 8 to the report detailed the movement in ear marked reserves.

In line with the IJB’s Reserves Policy the report sought approval of the draw-down of reserves, as required, to fund a number of projects now underway to support the development of new service delivery models and to improve the fabric of the estate as part of the key enablers which supported the delivery of the key workforce and property objectives set out within the Strategic Plan for 2022/25.

On behalf of the IJB, the Chair thanked those involved for the detail and accuracy in the reports and for the work undertaken as the position was constantly changing. 

DECIDED:

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

(b) That the projected year-end position for 2022/23 be noted; 

(c) That the current estimated financial assessment of the consequences of the COVID-19 pandemic for 2022/23 be noted; and

(d) That the draw-down of reserves from the IJB’s ‘accommodation premises investment fund’ be approved, as required, in support of projects now underway to support the development of new service delivery models and to improve the fabric of the estate, as detailed in paragraph 8.5 of the report.

The Head of Strategic Planning & Health Improvement submitted a report setting out the HSCP’s proposed performance scorecard for 2022/23.

The report intimated that the performance scorecard for 2022/23 had been reviewed and the report provided detail on the performance indicators removed from the scorecard; those targets which required to be amended; the new targets applied to existing indicators; and the new indicator added. Appendix 1 to the report detailed the proposed changes.

The report advised that the full scorecard updating all performance measures would be presented twice yearly, at mid-year and end of year 2022/23.

DECIDED: That the HSCP’s draft performance scorecard for 2022/23 be approved.

Under reference to item 17 of the Minute of the meeting of the IJB held on 24 June 2022, the Head of Strategic Planning & Health Improvement submitted a report providing an overview of the final version of the Renfrewshire Palliative and End of Life Care Strategy 2022/25. 

The report also provided an overview of the breadth of consultation carried out, the detailed feedback received and how this had been incorporated and reflected within the final strategy.

 

The report intimated that the Palliative Care Planning Group would be responsible for ensuring the commitments within the strategy were delivered upon. The group would prepare an annual plan, aligned to the strategy’s priorities, which would take account of any significant changes over the lifetime of the strategy such as new legislation and policy, demand trends and resource implications. The strategy and action plan would be reviewed and updated based on national plans which were expected to be published by the Scottish Government in 2023.

On behalf of the IJB, the Chair thanked those involved in compiling this strategy.

DECIDED: 

(a) That the final version of the Palliative and End of Life Care Strategy 2022/25, as detailed in Appendix 1 to the report, be approved;

(b) That the extensive consultation and engagement completed to ensure the final strategy was as informed and insightful as possible be noted; and

(c) That it be noted that the impact of the strategy would be appropriately monitored and evaluated by the Palliative Care Planning Group.

The Head of Strategic Planning & Health Improvement submitted a report providing an overview of the feedback received on the Unpaid Adult Carers’ Strategy, Short Breaks Services Statement for Unpaid Adult Carers and Unpaid Adult Carer Eligibility Criteria. 

The report intimated that, where appropriate, the feedback had been reflected within the final version of the documents, which were appended to the report for approval. Following approval, the documents would act as a framework for how Renfrewshire would support unpaid adult carers over the next three years.

The report set out the next steps, which focussed on delivering on the priorities and the high-level activities set out in the strategy. These activities would be linked to existing performance indicators where possible and be tracked and reported to the IJB through existing performance management processes.

On behalf of the IJB, the Chair thanked the team involved in reviewing these documents and the support provided to unpaid carers in Renfrewshire.
 
DECIDED:

(a) That the final version of the Unpaid Adult Carers’ Strategy 2022/25, the Short Breaks Services Statement for Unpaid Adult Carers 2022 and the Unpaid Adult Carer Eligibility Criteria 2022 be approved; and

(b) That the next steps outlined regarding delivery and monitoring of the priorities and high-level activities set out in the strategy, including the development of detailed underpinning actions in consultation with the wider unpaid adult carer community be noted.

The Head of Health & Social Care submitted a report relative to the HSCP’s Quality, Care and Professional Governance Annual Report for the period April 2021 to March 2022, which provided a variety of evidence to demonstrate the continued delivery of the governance core components within Renfrewshire HSCP and the clinical and care governance principles specified by the Scottish Government, a copy of which formed Appendix 1 to the report.

 

The report advised that the governance care components within Renfrewshire HSCP were based on service delivery, care and interventions that were person- centred, timely, outcome focused, equitable, safe, efficient and effective. Further, that arrangements remained in place to support enhanced multidisciplinary arrangements to support care home and care at home settings and that this aimed to provide granular scrutiny, support and oversight of care home and care at home settings.

DECIDED:

(a) That the content of the report, attached as Appendix 1, provided on HSCP governance to provide the necessary assurance to the IJB that services continued to operate safely and effectively, be noted; and   

(b) That the number of examples included within the report be noted.

The Head of Health & Social Care (Paisley) gave a presentation providing an update on winter planning funding for health and social care, confirmed by the Scottish Government in October 2021, which included the recruitment of health and care support workers.

The report provided further detail on addressing the key principles and areas for investment; the additional posts and funding that had created a unique opportunity to support staff and services to meet the challenges of increasing demand and the changing demographics within Renfrewshire; the new Home First Response Service (HFRS) which would be launched in autumn 2022 to work closely with community and acute teams to help provide alternatives to attendance and admission to hospital for people living with frailty; the continuing challenges faced; and the HSCP’s ongoing approach to delivering agreed proposals.

On behalf of the IJB, the Chair thanked those involved the work undertaken and in particular requested that thanks be passed to the district nursing team.

DECIDED: That the presentation be noted.

DECIDED: That it be noted that, as the meeting of the IJB Audit, Risk and Scrutiny Committee scheduled to be held on 9 September 2022 had been adjourned, the Chair would provide a verbal update at the next meeting of the IJB to be held on 25 November 2022.

DECIDED: That it be noted that the next meeting of the IJB would be held at 10.00 am on 25 November 2022 and that this meeting would be held remotely using MS teams.