Paper 26 East Ayrshire Health & Social Care Partnership Integration Joint Board 29 August 2018 at 2pm The Open Space, Ayrshire College, Hill Street, Kilmarnock Present: Councillor Douglas Reid, East Ayrshire Council (Chair) Mr Eddie Fraser, Director of East Ayrshire Health & Social Care Partnership Mr Alistair McKie, NHS Non-Executive Director Councillor Tom Cook, East Ayrshire Council Councillor Neil McGhee, East Ayrshire Council Councillor Ian Linton, East Ayrshire Council Ms Shirley Ferguson, Employee Representative, East Ayrshire Council Ms Hazel Borland, Nurse Director, NHS Ayrshire & Arran Mr Jim Baird, Stakeholder Forum Representative Ms Fiona Smith, AHP Senior Manager, NHS Ayrshire & Arran Prof. Ian Welsh, NHS Non-Executive Director Ms Yvonne Templeton, Stakeholder Forum Representative Mr Craig Stewart, Associate Nurse Director, NHS Ayrshire & Arran In Attendance: Ms Amanda McInnes, Senior Manager Business Support Mr Alex McPhee, Senior Manager Finance Mr Erik Sutherland, Senior Manager Planning and Performance Ms Maxine Ward, Senior Manager Community Health and Care Ms Linda Surgeoner, Senior Manager Community Health and Care Ms Jacqui McNeil, SDS Peer Mentor Ms Susan Taylor, Head of Children’s Health, Care & Justice Ms Pamela Milliken, Head of Primary Care & Out of Hours Community Response Services Mr Pat Kenny, Delloitte Dr Phil Korsah, Associate Medical Director, NHS Ayrshire & Aran Ms Aileen Anderson, Committee Secretary (Minutes) Agenda Discussion Action 1. Welcome & Apologies Councillor Reid welcomed everyone to the meeting and noted apologies from Dr Alexia Pellowe, Dr Brian O’Suilleabhain, Mr Gordon McKay, Dr Alison Towning and Dr Crawford McGuffie. 2. Minute of Previous Meeting held on 13 June 2018 The minute of the previous meeting were agreed as an accurate record of discussions. CLASSIFICATION: PUBLIC 3. Matters Arising Equipment and Adaptations: Stair Lifts It was noted that the Stair Lifts adaptations work is underway and an update report will be brought to the Board in March 2019. Financial Plan 2018/19 The Financial Plan was included in the agenda. Finance Plan 2018/19 The finance plan will be presented to the Audit & Performance Committee in December 2018. 4. Annual Performance Report and Wellbeing Delivery Plan Annual Report Mr Erik Sutherland presented the Annual Performance Report and Wellbeing Delivery Plan. It was noted that the Draft Annual Performance Report had been published online on 31 July 2018 and was approved by the Audit & Performance Committee on 14 August 2018. Discussion took place regarding the number of personal carers achieving SVQs and that this had reduced within the last year. It was highlighted that the Partnership had a strong partnership with Ayrshire College in delivery SVQs for personal carers which would include greater involvement from senior officers within the Partnership to provide input to ethos and values within future courses. The Board noted and agreed the following recommendations: i. Note that the Annual Performance Report has been approved by the Audit and Performance Committee at its meeting of 14 August 2018; ii. Approve the onward progress of the Annual Performance Report to partners to the Integration Scheme, specifically East Ayrshire Council on 20 September 2018 and to Ayrshire and Arran NHS Board on 08 October 2018; iii. Note that the Annual Performance Report and Wellbeing Delivery Plan Annual Performance Report will be presented to the joint meeting of the Council and Community Planning Partnership on 20 September 2018 and to the Community Planning Partnership on 27 September; and iv. Ensure the Chief Officer ensures that accessible version of the Annual Performance Report are publicly disseminated. 5. Audited Annual Accounts CLASSIFICATION: PUBLIC Mr Alex McPhee presented the report to advise the IJB of requirements introduced by the Local Authority Accounts (Scotland) Regulations 2004; present the Annual Accounts for the financial year ended 31 March 2018 and for the Board to consider the external auditors ISA 260 Report. It was noted that due to definitive management action to alleviate pressures and achieve cash releasing efficiency savings as well as an additional non-recurring allocation of £2.205m from East Ayrshire Council, the Partnership had spent les in 2017/18 than had been originally budgeted. ISA260 Report – External Audit Report Mr Pat Kenny confirmed that the ISA260 had been presented in full to the Audit and Performance Committee and that he was happy to sign the document providing reasonable assurance in the audit, advising that the financial statements of the Partnership were well executed and maintained. The Board noted and agreed the following recommendations: i. Note the audited final outturn position for the IJB for 2017/18; ii. Note the content of the Independent Auditor’s Report; iii. Note the content of the separate External Auditor’s ISA 260 report detailing the outcome of the audit as presented to the Committee; iv. Direct the Chief Finance Officer and Chief Auditor of the IJB to respond to recommendations for improvement as outlined in the Action Plan; and v. Approve the East Ayrshire Health and Social Care Partnership audited Annual Accounts. 6. Annual Budget Update Report Mr Alex McPhee presented the report to provide details of the updated budget position for the East Ayrshire Health and Social Care Partnership. The report presented the annual allocation from both integration partners and the financial savings from both NHS Ayrshire and Arran and East Ayrshire Council. The total approved delegated budget for 2018/19 £222.828m including Lead Partnership adjustments, Set Aside and delegated functions will allow the Partnership to proceed with service planning whilst delivering cash releasing efficiency savings and meeting its commitments for service areas with demand pressures. The Board were informed of an additional £199,000 Cash Releasing Efficiency Savings which had been allocated by the NHS to the IJB as a saving to address the current financial challenges. CLASSIFICATION: PUBLIC The Board noted and agreed the following recommendations: i. Note the 2017/18 budget delegated to the IJB by NHS Ayrshire & Arran £145.369m. This budget reduces to £135.295m when adjusted by £8.868m in respect of Scottish Government integration/ social care funding to offset Council commissioned service expenditure and by £1.206m in respect of Council commissioned mainlined Integrated Care Fund projects; ii. To Direct NHS Ayrshire & Arran to deliver services on behalf of the IJB within this £135.295m delegated resource in line with strategic planning priorities; iii. Approve the additional cash releasing efficiency savings proposal outlined; iv. Note the risks around delivery of additional cash releasing efficiency savings £0.400m on top of the initial £5.017m approved on 26 April 2018 including the impact of the exclusion of elements of Primary Care and Mental Health budgets from CRES and the wider risks; v. Note the additional risk on staffing budgets from the proposed £0.199m contribution to NHS corporate turnover targets; and vi. It was noted that there is an additional £3m NHs Ayrshire and Arran corporate staff turnover target of which it is proposed that £0.199m be allocated through a reduction of £0.199m in the NHS allocation to East Ayrshire IJB. The 2018/19 delegated budget does not include this recurring in- year adjustment at this stage. The IJB agreed that it is appropriate to approve this additional cash releasing efficiency saving pending the reduction to the budget whilst noting the operational risks associated with delivery of additional staff turnover savings going forward. vii. Note the programme of budget transformation and service reconfiguration being taken forward through the Strategic Commissioning for Sustainable Outcomes Programme Board including mitigating management action to achieve financial balance in the current financial year. 7. Financial Management Report to 31 July 2018 Mr Alex McPhee presented the report to provide details of the projected outturn position for the Partnership for 2018/19, based on the current financial position as at 31 July 2018. The initial approved budget excluding hosted services adjustments £230.213m had increased to £232.133m at 31 July 2018. The net increase related to additional funding allocations partially offset by other movements for the year-to-date for both Council and NHS delegated budgets for directly managed services. CLASSIFICATION: PUBLIC The Board noted and agreed the following recommendations: i. Note the projected outturn position for East Ayrshire Health and Social Care Partnership at July 2018, including specific key actions on significant variances; ii. Note the continuing projected overspend on children’s outwith placements and the continuing financial risk for the IJB in the current financial year; iii. Note progress towards achievement of approved cash releasing efficiency savings; iv. Note the projected outturn position in respect of services managed under Lead Partnership arrangement; and v. It was noted that there is an additional £3m NHs Ayrshire and Arran corporate staff turnover target of which it is proposed that £0.199m be allocated through a reduction of £0.199m in the NHS allocation to East Ayrshire IJB. The 2018/19 delegated budget does not include this recurring in- year adjustment at this stage. The IJB agreed that it is appropriate to approve this additional cash releasing efficiency saving pending the reduction to the budget whilst noting