Performance And Audit Committee (integration Joint Board) - 26/05/2021

At a MEETING of the PERFORMANCE AND AUDIT COMMITTEE OF THE DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held remotely on 26th May, 2021.

Present:-

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

Trudy MCLEAY, Chairperson, in the Chair.

Prior to the commencement of the business the Chairperson welcomed everyone to the meeting and reminded those in attendance that meetings would now be recorded with recordings placed on the website for public viewing following on from the decision of the Integration Joint Board at its meeting on 21st April, 2021. The Chairperson welcomed this development and her view that this would offer greater transparency and ability to share information on the work of the Committee with a wider audience.

I APOLOGIES FOR ABSENCE

Apologies for absence were submitted on behalf of:-

II DECLARATION OF INTEREST

There were no declarations of interest.

III MINUTE OF PREVIOUS MEETING

The minute of meeting of the Committee held on 3rd February, 2021 was submitted and approved.

Following questions and answers the Committee further agreed:-

(i) to note, that in relation to Article IV, steps would be made to reissue reports on Delayed Discharge to the membership of the Committee;

(ii) to note, in relation to Article VII, on the advice of the Chief Finance Officer, that the Partnership were exploring public information being placed on the website in general, separate to information on Voluntary Action Exercise Group and that this would be progressed;

(iii) to note, in relation to Article VIII, the Chairperson offered the view that in addition to the new style comprehensive minutes being provided that there would be benefit in an Action Plan being included which would indicate timelines and tracking of Actions and that this would be progressed by the Chief Finance Officer in consultation with the Clerk; and

(iv) to note, in relation to Article IX, that in terms of information on Risk Management that the Chief Finance Officer had had a meeting with Donald McPherson and that this was currently being progressed on a Tayside wide level.

IV MEMBERSHIP VOTING MEMBER

Reference was made to Article V of the minute of meeting of the Integration Joint Board held on 24th February, 2021, wherein it was noted that Councillor Lynne Short had replaced Councillor Roisin Smith as a voting member on the Integration Joint Board.

The Committee noted that the Integration Joint Board agreed to appoint Councillor Lynne Short to the vacant position on the Committee.

V DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP PERFORMANCE REPORT 2020/2021 QUARTER 3 SUMMARY

There was submitted Report No PAC10-2021 by the Chief Finance Officer updating the Performance and Audit Committee on the 2020/2021 Quarter 3 performance against the National Health and Wellbeing Indicators and Measuring Performance Under Integration indicators.

The Performance and Audit Committee:-

(i) noted the content of the summary report;

(ii) noted the performance of Dundee Health and Social Care Partnership, at both Dundee and Local Community Planning Partnership levels, against the National Health and Wellbeing Indicators as summarised in Appendix 1 of the report; and

(iii) noted the performance of Dundee Health and Social Care Partnership, against the Measuring Performance Under Integration indicators as summarised in Appendix 1 (table 2) of the report.

Following questions and answers the Committee further agreed:-

(iv) to note, following enquiry from the Chair in relation to section 4.4 of the report, the advice of the Strategy and Performance Senior Officer that indicators on balance of care and end of life data were being developed by the Scottish Government;

(v) to note, following enquiry from the Chair in relation to section 4.6 of the report, the advice of the Head of Health and Community Care that learning from the Covid Pandemic was being examined across a range of partnership services;

(vi) to note the advice of the Chief Internal Auditor, that in addition to learning being cascaded that a range of strategies currently in place would require review, and the advice of the Chief Officer that a report would be submitted to a future meeting of the Integration Joint Board on the Strategic Commissioning Plan highlighting these issues;

(vii) to note, following enquiry from Donald McPherson, that the Strategy and Performance Service Manager would undertake further analysis of the position in relation to the figures for the North East area to establish what learning could be achieved for the benefit of the other areas in Dundee;

(viii) to note, following enquiry from Councillor Lynne Short in relation to section 6.2.7, the advice of Dr Matthew Kendall that these percentages related to people who were admitted to a short stay ward which was classed as an admission in contrast to other areas;

(ix) to note, following enquiry from Bailie Helen Wright in relation to Table 4 which indicated that the Coldside area had the highest readmission rate in the City, that the Strategy and Performance Service Manager would examine recording patterns with the Strategy and Performance Senior Officer and report back to Bailie Helen Wright on the outcome; and

(x) to note, following enquiry from the Chairperson on definitions such as Code 9, the advice of the Strategy and Performance Service Senior Officer that these would be included in future reports.

VI DISCHARGE MANAGEMENT PERFORMANCE UPDATE ON COMPLEX AND STANDARD DELAYS

There was submitted Report No PAC11-2021 by the Chief Finance Officer updating the Performance and Audit Committee on Discharge Management performance in Dundee in relation to delays.

The Performance and Audit Committee: -

(i)                            noted the current position in relation to complex delays as outlined in section 5 of the report, and in relation to standard delays as outlined in section 6 of the report; and

(ii)                           noted the improvement actions planned to respond to areas of pressure as outlined in section 7 of the report.

Following questions and answers the Committee further agreed: -

(iii)                          to note, as advised by the Head of Health and Community Care, following enquiry from the Chairperson, that Mental Health Officers were Social Workers who had undertaken an additional qualification which was undertaken during the daytime and was funded by the Children and Families Service of Dundee City Council; and

(iv)                          to note, following enquiry from Councillor Lynne Short, that the Head of Health and Community Care would prepare a one page outline document showing an organisational graph of the Partnership and that this would be circulated to the full Committee.

VII LOCAL GOVERNMENT BENCHMARKING FRAMEWORK 2019/2020 PERFORMANCE

There was submitted Report No PAC12-2021 by the Chief Finance Officer informing the Performance and Audit Committee of the performance of Dundee Health and Social Care Partnership against the Health and Social Care Indicators in the Local Government Benchmarking Framework (LGBF) for the financial year 2019/2020.

The Performance and Audit Committee: -

(i)                            noted the performance detailed in the report and in Appendix 1 of the report;

(ii)                           approved the proposed targets for future rank set out in Table 1 of Appendix 1 of the report and described in section 4.6 of the report;

(iii)                          noted that LGBF performance information would be published on the Dundee City Council website; and

(iv) instructed the Chief Officer to work with partners, including Dundee City Council and Audit Scotland, to consider the value of the Health and Social Care Partnerships continued participation in the LGBF arrangements for adult social care.

Following questions and answers the Committee further agreed: -

(v) to note, following enquiry from the Chairperson, the advice of the Head of Health and Community Care, that prior to the Covid 19 pandemic, the partnership were actively working with Dundee Voluntary Service on participation of volunteers in care settings to assist with stimulating activities for the elderly and that the Partnership were currently looking at ways Adult Health Partnership Staff could take part in activities in Care Homes and that this feature in the Remobilisation Plan.

VIII DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP CLINICAL, CARE AND PROFESSIONAL GOVERNANCE ASSURANCE REPORT

There was submitted Report No PAC13-2021 by the Clinical Director providing assurance regarding matters of Government policy directives and legal requirements. This aligned to the safe, effective and person centred quality ambitions of NHS Scotland.

The report was brought to the Committee to provide assurance on the clinical and care governance activities and arrangements across the Partnership as outlined in the Getting It Right For Everyone (GIRFE) Framework in accordance with the Partnership Integration Scheme. Clinical Governance was a statutory requirement to provide, at Board level, from Scottish Government as per NHS MEL (1998) 75. The Performance and Audit Committee was asked to provide their view on the level of assurance the report provided in regard to clinical and care governance within the Partnership. The timescale for the data within the report included 1st December, 2020 to 31st January, 2021.

The Performance and Audit Committee: -

(i)                            noted the content of the report;

(ii)                           noted the Exception Report for the Dundee Health and Social Care Partnership Clinical, Care and Professional Governance Group as detailed in Section 4 of the report; and

(iii)                          agreed with the Lead Officer for Dundee Health and Social Care Partnership that the level of assurance provided was: Moderate.

Following questions and answers the Committee further agreed: -

(iv)                          to note, following enquiry from the Chairperson, the advice of the Head of Health and Community Care, that a pilot was currently in place for GPs with the aim of providing support for prescribing to aid the substance recovery journey and that Dr David Shaw was reviewing the service level agreement with GPs;

(v)                           to note, following enquiry from the Chairperson, that the Chief Social Work Officer would revise the content of future reports in consultation with the Chief Finance Officer and the Clerk on the need for an Equality Impact Assessment to be included with particular reference to Data Reports which could have an impact on carers groups and that as indicated by Dr Matthew Kendall he would outline levels of assurance in future reports;

(vi)                          to note the observation of Bailie Helen Wright on the benefit of information on Equality Impact Assessment being included in New Member Induction Training and the possibility of training not being confined to new members but offered as a refresher for the full membership. The Chief Finance Officer agreed to take this forward with Chief Internal Auditor and Audit Scotland would also be happy to be involved in any induction work, as advised by their representative; and

(vii)                         to note the view of the Chief Internal Auditor that the role of the Performance and Audit Committee was to look at the Risk Register and, if necessary, escalate matters to the Integration Joint Board, and that he would arrange for information to be shared with the Committee on Good Assurance Principles, and that this would be included in the Chairpersons Assurance report to the Integration Joint Board. The Chief Finance Officer would include these points within the Risk Register.

IX AUDIT SCOTLAND ANNUAL AUDIT PLAN 2020/2021

There was submitted Report No PAC14-2021 by the Chief Finance Officer on the proposed Dundee Integration Joint Board Annual Audit Plan 2020/2021 as submitted by the Integration Joint Boards appointed External Auditor (Audit Scotland).

The Performance and Audit Committee:-

(i)                            noted the content of the report; and

(ii)                           approved the proposed Audit Plan for 2020/2021 as submitted by Audit Scotland which was attached as Appendix 1 to the report.

Following questions and answers the Committee further agreed:-

(iii)                          to note that Audit Scotland would shortly be publishing their Annual Overview Report and that their representative would arrange for this to be provided to the membership of the Integration Joint Board for their interest;

(iv)                          to note, as advised by the Chairperson that an expression of interest had been made by a GP within a Dundee Practice in relation to the vacant position of GP member on the Integration Joint Board; and

(v)                           to note, following enquiry from Donald McPherson in relation to Exhibit 4 of the report and his question as to why Audit Scotland did not plan to place any reliance on work of Internal audit the advice of the Audit Scotland representative in reply that Reliance was not attached to Finance Statements.

X DUNDEE INTEGRATION JOINT BOARD INTERNAL AUDIT PLAN PROGRESS REPORT

There was submitted Report No PAC15-2021 by the Chief Finance Officer providing the Performance and Audit Committee with a progress update in relation to the 2020/2021 Internal Audit Plan.

The Performance and Audit Committee noted the continuing delivery of the audit plan and related reviews as outlined in the report.

The Performance and Audit Committee: -

(i) noted the continuing delivery of the audit plan and related reviews as outlined in the report;

(ii) agreed to the change in how remaining audit days for 2020/2021 were used; and

(iii) noted the revised recommendation priorities and assurance definitions for use in all future internal audit reports as set out in Appendix 2 of the report.

XI INTERNAL AUDIT ANNUAL PLAN 2021/2022

There was submitted Report No PAC16-2021 by the Chief Finance Officer seeking approval of the Annual Internal Audit Plan for Dundee Integration Joint Board (IJB) for 2021/2022 and for agreement to the appointment of the Chief Internal Auditor.

The Performance and Audit Committee:-

(i) agreed to the continuation of Fife, Tayside and Forth Valley Audit and Management Services (FTF) as the Integration Joint Boards lead internal auditors and therefore taking the role of Chief Internal Auditor;

(ii) approved the 2021/2022 Annual Plan as set out in Appendix 1 of the report; and

(iii) to note that no updates were required to the Internal Audit Charter as noted in section 4.2 of the report.

Following questions and answers the Committee further agreed:-

(iv) to note, following enquiry from Councillor Lynne Short, the advice of the Chief Social Work Officer, that the Dundee Health and Social Care Annual Performance Report was submitted to the Policy and Resources Committee of Dundee City Council and that the Partnership also contributed to the City Plan and that this assisted with all elected members being provided with information on the partnership.

XII GOVERNANCE ACTION PLAN PROGRESS REPORT

There was submitted Report No PAC17-2021 by the Chief Finance Officer providing the Committee with an update on the progress of the actions set out in the Governance Action Plan.

The Performance and Audit Committee: -

(i)            noted the content of the report and the progress made in relation to the actions set out in the Governance Action Plan as outlined in Appendix 1 of the report.

Following questions and answers the Committee further agreed: -

(i)                    to note, following enquiry from Donald McPherson in relation to dates for completion being pushed back on a number of occasions that it was considered by the Chief Finance Officer that timescales now indicated could be met; and

(ii)                   to note the view expressed by Councillor Lynne Short that the non-filling of the vacant GP position on the Integration Joint Board was not isolated to Dundee alone and that it may be a similar position in many other areas and that the Audit Scotland representative would consult with colleagues in Audit Scotland to examine the position nationally with a view to making a national recommendation if necessary.

XIII ATTENDANCE LIST

There was submitted Agenda Note PAC18-2021 providing a copy of the attendance return for meetings of the Performance and Audit Committee held to date over 2021.

The Performance and Audit Committee noted the position as outlined.

XIV DATE OF NEXT MEETING

The Committee noted that the next meeting of the Committee would be held remotely on Wednesday, 29th September, 2021 at 10.00 am (unless otherwise advised by the Chief Officer).

Trudy MCLEAY, Chairperson.