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4 Draft Minute of Argyll & Bute Health & Social Care Partnership (Hsc P) Integration Joint Board Wednesday 25 January 2017, Council Chambers, Kilmory

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4 Draft Minute of Argyll & Bute Health & Social Care Partnership (Hsc P) Integration Joint Board Wednesday 25 January 2017, Council Chambers, Kilmory Item : 4 DRAFT MINUTE OF ARGYLL & BUTE HEALTH & SOCIAL CARE PARTNERSHIP (HSCP) INTEGRATION JOINT BOARD WEDNESDAY 25 JANUARY 2017, COUNCIL CHAMBERS, KILMORY Present : Councillor Kieron Green Argyll & Bute Council (Chair) Robin Creelman NHS Highland Non-Executive Board Member (Vice Chair) Christina West Chief Officer, Argyll & Bute HSCP David Alston NHS Highland Chair Elaine Wilkinson NHS Highland Non-Executive Board Member (VC) Dr Michael Hall Associate Medical Director, Argyll & Bute HSCP Caroline Whyte Chief Financial Officer, Argyll & Bute HSCP Louise Long Chief Social Work Officer Dr Richard Wilson GP Representative Dr Peter Thorpe Secondary Care Adviser, Argyll & Bute HSCP Liz Higgins Lead Nurse, Argyll & Bute HSCP Elaine Garman Public Health Specialist, Argyll & Bute HSCP Denis McGlennon Independent Sector Representative Glenn Heritage Argyll & Bute Third Sector Interface Elizabeth Rhodick Public Representative Maggie McCowan Public Representative Catriona Spink Unpaid Carer Representative Heather Grier Unpaid Carer Representative Councillor Mary-Jean Devon Argyll & Bute Council Councillor Anne Horn Argyll & Bute Council Councillor Elaine Robertson Argyll & Bute Council Dawn MacDonald Staff Representative (NHS) Stephen Whiston Head of Strategic Planning & Performance Lorraine Paterson Head of Adult Services (West Allen Stevenson Head of Adult Services (East) David Ritchie Communications Manager (Health) Attending : Melanie Newdick NHS Highland Vice-Chair Sheena Clark PA to Chief Officer (Minutes) Apologies : Anne Gent Director of Human Resources, NHS Highland Linda Currie AHP Lead ITEM DETAIL ACTION 1 WELCOME The Chair welcomed everyone to the meeting. 1 2 APOLOGIES Apologies were as noted. 3 DECLARATIONS OF INTEREST Agenda item 5.2 - Councillor Devon advised that she is an ordained Elder of the Church of Scotland. 4 DRAFT MINUTE OF INTEGRATION JOINT BOARD 30-11-16 & ACTION LOG The Chief Officer reported that on 15 December 2016 the Policy & Resource Committee : • Approved the additional £0.110m funding in respect of the Living Wage, to be added to the IJB’s 2016-17 recurring baseline allocation. • Did not support the IJB’s request for an additional payment of £0.185m to support the implementation of the pause to the proposals at Struan Lodge and Thomson Court, requesting that the IJB looks for alternative savings and report back to the Council later in the financial year as required within the Scheme of Integration. 5 BUSINESS 5.1 Finance The Chief Financial Officer presented the reports. a) Budget Monitoring - robust budget monitoring processes are key to ensure the expenditure incurred by the IJB partners is contained within the approved budget for 2016-17 and overall the partnership delivers a balanced year-end outturn position. The projected year-end outturn position is an overspend of £1.1m and the IJB requires assurance this position can be brought back into line with the available budget by financial year-end. There are significant financial risks in terms of service delivery for 2016-17 and mitigating actions are in place to reduce or minimise these. The IJB noted the overall Integrated Budget Monitoring Report for the December 2016 period and the projected year-end overspend of £1.1m; noted the progress with the delivery of the Quality & Financial Plan and agreed the previously approved financial recovery plan requires to continue to be implemented to ensure delivery of a balanced integrated budget for the 2016-17 financial year. b) Budget Outlook 2017-18 and 2018-19 – the IJB is facing a challenging financial outlook with an estimated budget gap for integrated services of £16.3m and £5.7m for the remaining 2 years of the Strategic Plan. The outlook position has deteriorated significantly since the report to the IJB on 30 November 2016 following the Local Government and Health budget settlements. There is a particular 2 2 challenge for the IJB in producing a balanced budget by 31 March 2017, with the budget gap being very heavily weighted to 2017-18, with estimated reductions of 6.4% and 2.2% in each of the years. Indications are that one year financial offers will be submitted by both Health and Council partners. There remains a degree of uncertainty around the financial offers from the Health Board and Council and this budget outlook has been based on indicative information provided. Financial assumptions and budget outlook will be updated when there is more certainty around the budget allocations available and the cost and demand pressures. Councillor Devon highlighted the impact of a reduced resource allocation on the children who are currently in a continuing care setting. Heather Grier enquired about the availability of information on the detail of the resource allocation for all departments within the Council. The Chair advised that the information would be publicly available following the outcome of the Council’s budget setting meeting. The Vice-Chair requested that following the announcement of the Council’s funding settlement to the IJB, a rational is requested for any CWh reduction in funding for integrated care. Councillor Devon expressed concern regarding the Health & Social Care Partnership’s ability to comply with the delivery of statutory services due to the financial challenges. Enquiring about the impact of patient travel costs, Councillor Robertson was advised that reimbursement costs are now capped, irrespective of the cost to NHS Highland. Elaine Wilkinson enquired about the opportunity for apprenticeship levis. Caroline Whyte agreed to check the process for accessing CWh funding for apprenticeships. The IJB noted the indicative budgets and resulting budget gap for 2017-18 of £16.3m and for 2018-19 of £5.7m, and noted that this position has materially change from previous estimates following Local Government and Health funding settlement announcements. Noted that this is not the final position and there is still further clarity required around cost and demand pressures and the funding offers from both partners. Noted the requirement for the IJB to approve a balanced Integrated Budget by 31-3-17 and noted the ongoing requirement for development of the Quality & Financial Plan for the next two years in line with the updated estimated budget gap and the previously agreed timeline. c) Audit Committee – Minutes of 3-8-16 The IJB noted the Minutes of the quarterly meeting. 3 3 5.2 Auchinlee Care Home Update Following the decision by the IJB in November 2016, the HSCP has continued their engagement with CrossReach and interested parties in an attempt to agree a viable and sustainable arrangement to retain Auchinlee Care Home. Formal notification from CrossReach in January 2017 indicated their proposal to keep the care home open for a further 3 months to March 2017, with the losses incurred to be shared between CrossReach and the HSCP. The HSCP Strategic Management Team (SMT) continues to be thoughtful and mindful of the impact the closure of Auchinlee Care Home would have on the residents, their families and the community. However, following further engagement and discussions with CrossReach and community bodies, the SMT have confirmed their view that the proposal from CrossReach will expose the HSCP to a significant risk in terms of resident safety and quality of care, service sustainability and financial impact. In view of this the SMT have recommended that they are unable to support the funding request of £60k to CrossReach to underwrite their losses in January-March 2017. The HSCP continue to work to develop a proposal which is safe and sustainable to keep the service locally. The IJB discussed the recommendations in the report and supported the SMT’s conclusion regarding the funding request of £60k. The IJB acknowledged the impact the closure of Auchinlee Care Home will have on residents, families and the community. Councillor Anne Horn dissented at the IJB’s decision to support the SMT’s recommendation. The IJB noted the update on the further meeting of the HSCP with Crossreach following the recommendation of the IJB to enter further discussions. The IJB considered the implications of the revised proposal from CrossReach and supported the recommendations from the Strategic Management Team as detailed in the paper and noted the HSCP are continuing to work on alternative provision for existing residents of Auchinlee within and outwith Kintyre. The proposal to undertake a care summit to develop a future model of care for Elderly care for the West of Argyll was noted. 5.3 Public Health – Update on Suicide Prevention & Mental Health Improvement Work The Public Health Specialist provided a report summary, outlining the work undertaken in 2016 and the planned work in 2017 and beyond. She advised on the changes and the work planned on suicide prevention and prevention of self harm which has now been 4 4 mainstreamed into work within mental health and public health. It is expected that the changes will support a mentally healthy Argyll & Bute, with awareness to be raised through work streams in other areas of integrated working. Glenn Heritage highlighted the ‘Breathing Space’ initiative, which is being supported by the Third Sector Interface, and the importance of the use of social media to communicate a positive message to young people. The IJB noted the paper and supported agreement to access free training venues across community planning partners to minimise training costs. 5.4 Clinical & Care Governance The report presented by the Lead Nurse provided updates on : HSCP Complaints - work is continuing to develop reporting for HSCP Health complaints and Social Work complaints. Improvement work is being tested and support is being provided to identify the key points of a complaint which requires to be investigated and a plan provided. Scottish Inpatient Experience Survey – hospitals have been asked to consider their particular reports. Local Teams have developed an improvement plan which is being monitored. Mandatory Training Compliance – HR and Clinical Governance teams are working to develop a system to provide the required compliance information.
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