Dundee City Health & Social Care Integration Joint Board - 25/06/2019

At a MEETING of the DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held at Dundee on 25th June, 2019.

Present:-

Non members in attendance at the request of the Chief Officer:-

Trudy McLEAY, Chairperson, in the Chair.

Prior to the commencement of the business, the Chairperson advised of the forthcoming retiral of Jane Martin, Chief Social Work Officer. Both the Chairperson and the Vice Chairperson paid tribute to the contribution Jane Martin had made to the work of Health and Social Care in Dundee over the years in her capacity as a Head of Service with Dundee City Council and her role in furthering this work through the Dundee Health and Social Care Partnership. The Chairperson also took the opportunity to welcome Dr James Cotton to his first meeting of the Integration Joint Board. Tribute was also paid to Sarah Dickie who had now been nominated by NHS Tayside to serve on Perth and Kinross Integration Joint Board and thanks were conveyed for her contribution to the Dundee Integration Joint Board over her period of membership.

I APOLOGIES FOR ABSENCE

Apologies for absence were submitted on behalf of:-

II DECLARATION OF INTEREST

No declarations of interest were made.

III MINUTE OF PREVIOUS MEETING

The minute of previous meeting of the Integration Joint Board held on 23rd April, 2019 was submitted and approved.

IV PERFORMANCE AND AUDIT COMMIITTEE

(a) MINUTE OF PREVIOUS MEETING OF 28TH MAY, 2019

The minute of the previous meeting of the Performance and Audit Committee held on 28th May, 2019 was submitted and noted for information and record purposes.

(b) CHAIRS ASSURANCE REPORT

There was submitted Report No DIJB38-2019 by Ken Lynn, Chairperson of the Performance and Audit Committee, providing an Assurance Report to the Integration Joint Board on the work of the Performance and Audit Committee.

The Integaration Joint Board agreed to note the content of the report.

V MEMBERSHIP OF DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD REGISTERED NURSE

Reference was made to Article III(c) of the minute of meeting of this Integration Joint Board held on 30th October, 2018, wherein it was noted that NHS Tayside had nominated Sarah Dickie to be a member of the Integration Joint Board in the capacity of Registered Nurse.

It was reported that NHS Tayside had now nominated Sarah Dickie to serve on Perth and Kinross Integration Joint Board and that Kathryn Brechin, Associate Nurse Director Designate had been nominated as her replacement to the position of Registered Nurse on Dundee Integration Joint Board effective from 1st August, 2019.

The Integration Joint Board agreed to note the appointment.

VI PRESENTATION THE FAIRNESS COMMISSIONS MENTAL HEALTH RECOMMENDATIONS

A joint presentation was made by former Commissioners of the Dundee Fairness Commission. The presentation covered Mental Health recommendations that came out of the research during the Commission which took place over 2018 including the need for a 24/7 Mental Health drop-in service in collaboration with beneficiaries and offering clinical, non-clinical, therapeutic and peer support and training for service providers and frontline staff (including GP Surgeries) to:-

-                               raise awareness of the impact of poverty on mental health

-                               improve interactions with service users

-                               support prevention and early intervention

-                               increase referrals/signposting to non-clinical mental health support

The Integration Joint Board noted the content of the presentation and, following questions and answers, thanked the presenters for their contribution.

VII SELF EVALUATION FOR THE REVIEW OF PROGRESS WITH INTEGRATION OF HEALTH AND SOCIAL CARE

Reference was made to Article VI of the minute of meeting of this Integration Joint Board held on 26th February, 2019 wherein the update progress report on Audit Scotland Health and Social Care Integration was submitted.

There was submitted Report No DIJB27-2019 by the Chief Officer presenting the self-evaluation of the current position in Dundee in relation to the Ministerial Strategic Group for Health and Community Cares report on review of progress with integration.

The Integration Joint Board agreed:-

(i) to approve the final self-evaluation document which was attached to the report as Appendix 1 and instruct the Chief Officer to submit the document to the Ministerial Strategic Group;

(ii) to note that a draft self-evaluation was previously submitted to the Ministerial Strategic Group to comply with the deadline for return of 15th May, 2019 as outlined in section 4.3 of the report; and

(iii) to instruct the Chief Finance Officer, as Chair of the Integration Strategic Planning Group, to take forward the improvement actions with dates identified through the self-evaluation process in partnership with Dundee City Council and NHS Tayside and report progress to the Integration Joint Board no later than 17th December, 2019.

VIII ANNUAL PERFORMANCE REPORT 2018/19

There was submitted Report No DIJB24-2019 by the Chief Officer submitting the Health and Social Care Partnership Annual Performance Report 2018/19 for approval.

The Integration Joint Board agreed:-

(i) to note the updates provided, including that a summary version of the Annual Performance Report 2018/19 would be produced for publication;

(ii) to approve the Annual Performance Report 2018/19 which was attached to the report as Appendix 1; and

(iii) to approve the planned approach to formatting, publication and distribution as outlined in sections 4.2.3 and 4.2.4 of the report.

IX FINANCIAL MONITORING YEAR END POSITION

Reference was made to Article XIII of the minute of meeting of this Integration Joint Board held on 28th August, 2018 wherein the report on Dundee Integration Joint Board 2018/2019 Budget for Delegated Services was submitted.

There was submitted Report No DIJB34-2019 by the Chief Finance Officer providing an overview of the final financial position for delegated health and social care services for 2018/2019.

The Integration Joint Board agreed to note the content of the report including the year end outturn for delegated services to the 2018/2019 financial year end as at 31st March, 2019 as outlined in Appendices 1, 2 and 3 of the report.

X DUNDEE INTEGRATION JOINT BOARD ANNUAL INTERNAL AUDIT REPORT 2018/2019

Reference was made to Article XI of the minute of meeting of the Performance and Audit Committee of 31st July, 2018 wherein the report on Dundee Integration Joint Board Annual Internal Audit Report 2017/2018 and Annual Governance Statement was submitted.

There was submitted Report No DIJB35-2019 by the Chief Finance Officer advising of the outcome of the Chief Internal Auditors report on the Integration Joint Boards internal control framework for the financial year 2018/2019.

The Integration Joint Board agreed:-

(i) to note the content and findings of the Annual Audit Report 2018/2019 which was attached to the report as Appendix 1; and

(ii) to instruct the Chief Finance Officer to incorporate the recommendations of the report into the Integration Joint Boards Governance Action Plan, presented to and monitored by the Performance and Audit Committee.

XI DRAFT ANNUAL ACCOUNTS 2018/2019

There was submitted Report No DIJB30-2019 by the Chief Finance Officer presenting the Integration Joint Board's Draft Annual Statement of Accounts 2018/2019 for approval to initiate the external audit process.

The Integration Joint Board agreed:-

(i) the content of the Draft Final Accounts Funding Variations as outlined in Appendix 1 of the report;

(ii) to approve the Draft Dundee Integration Joint Board Annual Corporate Governance Statement as outlined in Appendix 2 of the report;

(iii) to note the Integration Joint Board's Draft Annual Statement of Accounts 2018/2019 as outlined in Appendix 3 of the report;

(iv) to note the application of reserves during 2018/2019 to meet the Integration Joint Board's liabilities and support its activities during the financial year as outlined in 4.1.3. of the report; and

(v) to instruct the Chief Finance Officer to submit the Accounts to the Integration Joint Board's External Auditors (Audit Scotland) to enable the audit process to commence.

XII DUNDEE INTEGRATION JOINT BOARD FINAL 2019/2020 BUDGET

Reference was made to Article VI of the minute of meeting of this Integration Joint Board of 29th March, 2019 wherein the report on Dundee Integration Joint Board 2019/2020 Budget was submitted.

There was submitted Report No DIJB31-2019 by the Chief Finance Officer presenting NHS Taysides formal budget offer to Dundee Integration Joint Board in relation to the delegated budget 2019/2020 and setting out the implications of this and Dundee City Councils budget offer on the Integration Joint Boards final 2019/2020 budget.

The Integration Joint Board agreed:-

(i) to note and adopt the formal delegated budget offer to Dundee Health and Social Care Partnership from NHS Tayside as set out in sections 4.2 to 4.6 of the report;

(ii) to instruct the Chief Officer and Chief Finance Officer to continue discussions with the Chief Executive and Director of Finance of NHS Tayside in relation to Dundees prescribing budget allocation as set out in section 4.3 of the report;

(iii) to note the total value of Dundee Integration Joint Boards delegated budget for 2019/2020 as set out in Table 3 of the report;

(iv) to note the Dundee share of additional Scottish Government funding for Mental Health and Primary Care Transformation Funding as set out in section 4.6 of the report;

(v) to note the level of unidentified savings within the delegated budget as an implication of the level of resources provided by NHS Tayside and Dundee City Council for 2019/2020 set against anticipated financial pressures remained at 546k as set out in section 4.1.1 of the report and instruct the Chief Finance Officer to reflect the ongoing financial position through the financial monitoring reports presented to the Integration Joint Board throughout the financial year;

(vi) to instruct the Chief Finance Officer to inform Dundee City Council and NHS Tayside of the significant risk of the Integration Joint Board being unable to deliver a balanced budget by the year ended 31st March, 2020 as set out in section 3.0 of the report;

(vii) to note the Dundee share of additional Scottish Government funding for Mental Health and Primary Care Transformation Funding as set out in section 4.6 of the report; and

(viii) to remit the Chief Officer to issue directions to Dundee City Council and NHS Tayside as indicated in section 6 and the appendix to the report.

XIII DUNDEE PRIMARY CARE IMPROVEMENT PLAN UPDATE

Reference was made to Article IX of the minute of meeting of this Integration Joint Board of 28th August, 2018 wherein an update report was submitted on the Dundee Primary Care Improvement Plan.

There was submitted Report No DIJB33-2019 by the Chief Officer providing an update on the implementation of the Dundee Primary Care Improvement Plan for 2018/2019 and seeking approval for the implementation of the Dundee Primary Care Improvement Plan for 2019/2020.

The Integration Joint Board agreed:-

(i) to note the positive progress to implement the Dundee Primary Care Improvement Plan 2018/2019 in the first year of delivery which was attached to the report as Appendix 1 and noted in section 4.3 of this report;

(ii) to approve the proposed actions for Dundee Health and Social Care Partnership for 2019/2020 as described in Appendix 1 of the report and note the proposed allocation of funding as detailed in section 3 of the report;

(iii) to instruct the Chief Officer to issue directions to NHS Tayside to implement with immediate effect the specific actions relevant to them as outlined in Appendix 1 of the report;

(iv) to note the previous agreement to delegate the monitoring of the Dundee allocation of the Primary Care Improvement Fund as noted in section 4.2 of the report;

(v) to instruct the Chief Officer to provide a further report on progress made in the second year of delivering the Dundee Primary Care Improvement Plan to a future meeting of the Integration Joint Board; and

(vi) to note that a Tayside Primary Care Improvement Plan 2019/2020, incorporating the Dundee Primary Care Improvement Plan, would be submitted to the Scottish Government following approval by the relevant parties including Dundee Integration Joint Board.

XIV CARERS (SCOTLAND) ACT FUNDING INVESTMENT PLAN 2019/2021

Reference was made to Article XIV of the minute of meeting of this Integration Joint Board of 18th December, 2018 wherein an update report was submitted in relation to progress in implementing the Carers (Scotland) Act 2016 and Carers Investment Plan 2018/2019.

There was submitted Report No DIJB28-2019 by the Chief Officer providing information about progress with implementation of the Carers Strategic Plan, Carers (Scotland) Act 2016 and seeking approval for the Carers (Scotland) Act Investment Plan 2019/2021.

The Integration Joint Board agreed:-

(i) to note progress made in implementing the Carers Strategic Plan as outlined in section 4.1.3 of the report;

(ii) to note the intention for the use of the Carers (Scotland) Act Funding 2019/2020 as described in sections 4.2 and 4.3 of the report;

(iii) to approve the Carers (Scotland) Act Funding 2019/2020 Investment Plan for 2019/2020 which was attached to the report as Appendix 2; and

(iv) to remit the Chief Officer to issue the directions to Dundee City Council and NHS Tayside as set out in section 8.0 of the report and as attached at Appendix 1 of the report.

XV PROPOSAL TO DEVELOP A DUNDEE AND ANGUS COMMUNITY AND SCHOOLS EQUIPMENT LOAN SERVICE

There was submitted Report No DIJB26-2019 by the Chief Officer providing information about the Dundee and Angus Community Equipment Loan Service and the proposal to further develop the service to a Dundee and Angus Community and Schools Equipment Loan Service;

The Integration Joint Board agreed:-

(i) to approve, in principle, the proposal to proceed with development of a Dundee and Angus Community and Schools Equipment Loan Service; and

(ii) to instruct the Chief Officer to further progress discussions with Dundee and Angus Council, on the development of a Dundee and Angus Community and Schools Equipment Loan Service and to report back to a meeting of the Integration Joint Board for a decision to be made on the outcome of discussions.

XVI SUBSTANCE MISUSE SERVICE REDESIGN UPDATE

Reference was made to Article XIII of the minute of meeting of this Integration Joint Board of 18th December, 2018 wherein the Substance Misuse Redesign Plan was approved and it was agreed that an update report on progress be submitted to this meeting of the Integration Joint Board.

There was submitted Report No DIJB25-2019 by the Chief Officer providing an update about the progress with the redesign of Substance Misuse Services.

The Integration Joint Board agreed:-

(i) to note the Substance Misuse Service Redesign progress described at section 4 of the report; and

(ii) to request a report on progress with the redesign programme be submitted to the meeting of the Integration Joint Board to be held on 29th October 2019.

XVII PROPOSED MODEL OF CARE FOR OLDER PEOPLE WITH MENTAL HEALTH NEEDS BUSINESS CASE

Reference was made to Article VIII of the minute of meeting of this Integration Joint Board held on 27th June, 2017 wherein the report on Remodelling of Care for Older People was submitted.

There was submitted Report No DIJB29-2019 by the Chief Officer providing the business case for the proposed model of care for older people with mental health needs, including dementia, that was outlined in the Remodelling Care for Older People report presented to the Integration Joint Board on 27th June, 2017. The national strategic direction for these changes was outlined in the Scottish Governments Reshaping Care for Older People policy, Scotlands National Dementia Strategy (2017-2020) and The Future Model of Residential Care for Older People (2014) with the local strategic direction set through the Dundee Frailty Strategic Planning Group.

The Integration Joint Board agreed:-

(i) to note the content of the report and the remodelling which had taken place to support older people with mental health needs, including dementia, as described in section 4.1 of the report; and

(ii) to approve the business case as outlined in section 4.2 of the report and the associated financial framework as noted in section 3.0 of the report.

XVIII UPDATE ON DELAYED DISCHARGE, UNSCHEDULED CARE AND WINTER PRESSURES IMPROVEMENT PROGRAMMES

There was submitted Report No DIJB36-2019 by the Chief Officer detailing the progress made against the Home and Hospital Transition Improvement Plan 2018/2019 and providing an update on the work of the Unscheduled Care Board. In addition the paper reported on the performance to manage patient flow during the winter period and seeking agreement to sign off the Tayside area report to the Scottish Government which described the Tayside Performance during the winter period 1st November, 2018 to 31st March, 2019.

The Integration Joint Board agreed:-

(i) to note progress made against the 2018/2019 Home and Hospital Transition Improvement Plan as reported in section 4.2 and as detailed in Appendix 1 of the report;

(ii) to note the work of the Unscheduled Care Board during the previous financial year and the change projects associated with this work-stream as detailed in section 4.3 of the report;

(iii) to note the progress made in implementing the winter plan during 2018/2019 as detailed in section 4.4 and Appendix 2 of the report;

(iv) to note the requirement to produce a winter plan for 2019/2020 and request that this be submitted to a meeting of the Integration Joint Board for consideration prior to submission to the Scottish Government; and

(v) to approve the report on the progress made across Tayside during the winter period 2018/2019 as attached at Appendix 2 of the report and confirm agreement for the report to be signed off for submission to the Scottish Government.

XIX ANNUAL REPORT OF THE DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP CLINICAL, CARE AND PROFESSIONAL GOVERNANCE GROUP

There was submitted Report No DIJB32-2019 by the Chief Officer providing information to the Integration Joint Board regarding matters of Clinical, Care and Professional Governance. In addition, the report provided information on the business of the Dundee Health and Social Care Partnership Clinical, Care and Professional Governance Group, previously known as R2, and to outline the ongoing planned developments to enhance the effectiveness of the group.

The Integration Joint Board agreed:-

(i) to note the content of the report;

(ii) to note the progress made against the Annual Work Plan as attached at Appendix 1 of the report; and

(iii) to note the work undertaken by the Dundee Health and Social Care Partnership Clinical, Care and Professional Governance Group (R2) from April, 2018 to April, 2019 to seek assurance regarding matters of Clinical, Care and Professional Governance as outlined in sections 4.2 to 4.5 of the report.

XX MEETINGS OF THE INTEGRATION JOINT BOARD 2019 ATTENDANCES

There was submitted Agenda Note DIJB37-2019 providing a copy of the attendance return for meetings of the Integration Joint Board held to date over 2019.

The Integration Joint Board agreed to note the position as outlined.

XXI DATE OF NEXT MEETING

The Integration Joint Board agreed to note that the next meeting of the Integration Joint Board would be held in Committee Room 1, 14 City Square, Dundee on 27th August, 2019.

Trudy McLEAY, Chairperson.