Dundee City Health & Social Care Integration Joint Board - 23/06/2021

At a MEETING of the DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held remotely on 23rd June, 2021.

Present:-

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

Ken LYNN, Chairperson, in the Chair.

Prior to commencement of the business the Chief Officer took the opportunity to appraise the Integration Joint Board of the current position in relation to the ongoing health emergency and operational management of this which was noted.

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 Integration Joint Board held on 21st April, 2021 was submitted and approved.

Following questions and answers the Integration Joint Board further agreed to note, that, in relation to Article II of the minute, the advice of the Chief Finance Officer in reply to Donald McPherson that the Partnership would now look to hold the development session on Risk Management in late August 2021.

IV MEMBERSHIP OF DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD

(a) MEMBERSHIP NHS TAYSIDE NOMINATION POSITION OF VOTING MEMBER

Reference was made to Article III(a) of the minute of meeting of this Integration Joint Board held on 30th October, 2018, wherein it was noted that Jenny Alexander had been nominated by NHS Tayside to serve as a Voting Member on the Integration Joint Board.

It was reported that, at the meeting of the NHS Tayside Board held on 29th April, 2021, it was agreed that Anne Buchanan be nominated to be a member of the Integration Joint Board as replacement for Jenny Alexander in the capacity of Voting Member.

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

(b) MEMBERSHIP NHS TAYSIDE APPOINTMENT PROXY MEMBER

It was reported that, at the meeting of NHS Tayside Board held on 29th March, 2021, it was agreed that Jenny Alexander be appointed as a Proxy Member for the NHS Voting Members on the Integration Joint Board.

The Integration Joint Board agreed to note the position and that Jenny Alexander may attend as a Proxy Member for the NHS Tayside Voting Members on the Integration Joint Board.

V PERFORMANCE AND AUDIT COMMITTEE

(a) MINUTE OF PREVIOUS MEETING OF 26TH MAY, 2021

The minute of the previous meeting of the Performance and Audit Committee held on 26th May, 2021 was submitted and noted for information and record purposes.

The Integration Joint Board agreed to note the content of the minute.

Following questions and answers the Integration Joint Board further agreed:-

(i) to note, in relation to Article III of the minute, that the Chief Finance Officer advised that discussion had taken place with the Clerk on the establishment of an Action Tracker as an accompaniment to the minutes and this would be provided from the meeting in August 2021.

(b) CHAIRS ASSURANCE REPORT

There was submitted Report No DIJB36-2021 by Trudy McLeay, 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 Integration Joint Board agreed to note the content of the report.

VI PREPARATION OF THE INTEGRATION JOINT BOARDS ANNUAL PERFORMANCE REPORT 2020/2021

There was submitted Agenda Note No DIJB27-2021 reporting that Section 42 of the Public Bodies (Joint Working) (Scotland) Act 2014 stated that Integration Authorities must prepare an annual performance report for each reporting year. A performance report was described as a report which set out an assessment of performance by each Integration Authority in planning and carrying out its integration functions. The Public Bodies (Content of Performance Reports) (Scotland) Regulations 2014 set out the prescribed content of an annual report prepared by an Integration Authority in terms of Section 42 of the Act. There was a requirement for each Integration Authority to publish their annual performance report within four months of the end of the reporting year. The fifth annual report of the Dundee Health and Social Care Partnership (for 2020/2021) was therefore due for publication by 31st July 2021.

Since 2017 the Partnership had published a summary version of the annual performance report by 31st July following consultation with all Integration Joint Board members and formal approval of the content and format by the Chairperson, Vice‑Chairperson and Clerk of the Integration Joint Board, Chief Officer, Chief Finance Officer and the Head of Service - Health and Community Care. The summary version had been developed to meet the requirements of the regulations, including information regarding progress against the National Health and Wellbeing Outcomes and information at Partnership and locality level in relation to financial planning and performance, best value and scrutiny / inspection. The Scottish Government had previously indicated that this approach was acceptable, as had the Clerk.

The Integration Joint Board agreed:-

(i) to note that, consistent with the approach agreed by the Integration Joint Board at its meeting held on 25th August, 2020 (Article VIII of the minute refers), it was not intended to utilise the provisions of the Coronavirus (Scotland) Act 2020 Schedule 6, Part 3 to delay publication of the annual performance report until a date after 31st July, 2021 but prior to 30th November, 2021; and

(ii) to note that, to support transparency and public scrutiny, a summary version would be published on or before the statutory deadline (31st July, 2021), with a full version submitted to the Integration Joint Board no later than 27th October, 2021 for approval and subsequent publication.

VII LEADERSHIP OF PUBLIC PROTECTION ARRANGEMENTS

There was submitted Report No DIJB28-2021 by the Chief Officer updating the Integration Joint Board regarding arrangements for leadership of the strategic public protection agenda by the Chief Officers (Public Protection) Strategic Group, including key developments over the last six months and future strategic ambitions.

The Integration Joint Board agreed:-

(i) to note the role of the Chief Officers (Public Protection) Strategic Group in providing leadership for the protection of children and adults at risk as outlined in section 4.2 of the report;

(ii) to note the work undertaken by the Chief Officers (Public Protection) Strategic Group over the last six months to enhance arrangements for public protection, including the response to the second wave of the COVID-19 pandemic as outlined in sections 4.3 and 4.5 of the report; and

(iii) to note the priorities for the Chief Officers (Public Protection) Strategic Group for the next six months as outlined in section 4.6 of the report.

Following questions and answers the Integration Joint Board further agreed:-

(iv) to note that training on Trauma Informed Leadership was being held as indicated by Anne Buchanan, and her request that this be extended to the membership of the Integration Joint Board;

(v) to note, following observation from Bailie Helen Wright in relation to rise in homelessness as outlined in the report, that the Strategy and Performance Service Manager would contact Housing and Communities Service Manager for further information on background to this and provide the membership with analysis of this;

(vi) to note, following enquiry from Trudy McLeay in relation to some Public Protection Bodies having Independent Chairs and not others such as Suicide Prevention and Humanitarianism, that the Chief Social Work Officer would provide information on Governance Arrangements in her next report to the Integration Joint Board on Suicide Prevention;

(vii) to note, following enquiry from Councillor Lynne Short in relation to current work being undertaken on Trauma and the impact on older people in the community that the Strategy and Performance Service Manager advised that studies were being done and that she would look to collate information from the Trauma Steering Group for possible update to the Integration Joint Board; and

(viii) to note the advice of the Chief Officer that the effect of trauma was being examined at a national level and the recognition that, separate to the impact on staff, there was an impact across the whole population, including older people and children making transition from school.

VIII STRATEGIC AND COMMISSIONING PLAN COVID IMPACT AND STRATEGIC REVIEW

There was submitted Report No DIJB29-2021 by the Chief Officer updating the Integration Joint Board regarding progress made by the Strategic Planning Advisory Group to assess the impact of the second wave of the COVID-19 pandemic on the delivery of priorities and actions within the Strategic and Commissioning Plan 2019/2020 and considerations in relation to the timescale and approach to the statutory review of the Plan.

The Integration Joint Board agreed:-

(i) to note the contents of the report, including ongoing work led by the Strategic Planning Advisory Group, to assess the impact of the second wave of the COVID-19 pandemic on the delivery of the current strategic and commissioning plan and of a range of factors on the planned approach and timeline for the statutory review of the plan as outlined in section 4.6 of the report; and

(ii) to instruct the Chief Officer, on behalf of the Strategic Planning Advisory Group, to make detailed recommendations to the Integration Joint Board regarding the approach and timeline for completion of the statutory review of the strategic and commissioning plan no later than 27th October, 2021.

Following questions and answers the Integration Joint Board further agreed:-

(iii) to note, following enquiry from the Staff Partnership Representative on the Living Wage and the compliance of providers in this respect, the explanation from the Chief Finance Officer in relation to current tender process for commissioning work and that this included the provision of information on Fair Work practices and terms and conditions of employment of any prospective provider, and that the Strategy and Performance Services Manager would arrange for a companion document on this to be provided alongside the next report on Strategic Commissioning in October 2021;

(iv) to note, following the concerns of Trudy McLeay and Donald McPherson that, in terms of Care in the Community Provision, they had become aware that some providers only provided payment to staff for time spent in the persons home and not travel to those homes which would be undertaken in their own time, the assurance given by the Head of Health and Community Care that the Partnership would be looking at this in terms of Fair Work in future and that she would further arrange for a report to be submitted to the next meeting of the Integration Joint Board on this in consultation with the Staff Partnership Representative and the Trade Union Representative;

(v) to note the observation of Trudy McLeay that Care Workers should have advancement possibilities available to them in their work and that as, indicated by Bailie Helen Wright, the importance Care Workers had to their vulnerable clients; and

(vi) to note, as advised by Councillor Lynne Short, that there was currently a campaign in Dundee called Make Dundee a Living Place and that the Partnership may wish to get in touch with the Steering Group behind the Campaign.

IX DUNDEE INTEGRATION JOINT BOARD 2021/2022 BUDGET

Reference was made to Article IV of the minute of meeting of this Integration Joint Board held on 26th March 2021 wherein the 2021/2022 Delegated Budget was approved. There was submitted Agenda Note No DIJB30-2021 reporting that at the time the budget was set, there were two areas where further funding confirmation was required which resulted in the following recommendations being agreed to, namely:

- to instruct the Chief Finance Officer to report back to the Integration Joint Board following receipt of formal notification from Tayside NHS Board of the budget offer with associated recommendations including any implications of the finalisation of hosted services budgets and the Large Hospital Set Aside on the Integration Joint Boards net budget position and associated savings.

- to Instruct the Chief Finance Officer to report back to the Integration Joint Board on the implications to the Integration Joint Board's budget should the additional funding received by the Integration Joint Board to implement the national living wage policy vary from the anticipated cost.

NHS Tayside Board met to agree its Strategic Financial Plan 2021/2022 on 29th April 2021 and the Chief Finance Officer had received confirmation that the previous indicative uplift figures to the NHS delegated budget had been approved and were therefore regarded as final figures with the exception of a figure for the Large Hospital Set Aside which was yet to be determined. Therefore no amendment was required to the Integration Joint Boards delegated budget at this stage.

The Scottish Government had now confirmed Dundees share of additional funding provided to meet in full the cost of implementing the living wage for all adult social care workers, including the national policy direction to increase the value of all eligible contractual arrangements by 2.2% in 2021/2022. This additional funding recognised a shortfall in the original national allocation of funding for implementation of the policy which the Integration Joint Board was offsetting through its savings plan in addition to an increased commitment of the policy through the national 2.2% contractual uplift. This had resulted in additional funding not budgeted for within the original Integration Joint Boards Budget proposal of 906k, offset by an additional cost of the policy of 290k. This left net additional funding of 616k.

The Integration Joint Board agreed that the additional funding was utilised to reduce the Integration Joint Boards required 2021/2022 savings programme as follows to ease financial pressure on services during the year and to support the remobilisation of services:-

Reduce Anticipated Staff Turnover Saving from 700k to 350k (reduction of 350k)

Reduce Discretionary Spend Saving from 300k to 175k (reduction of 125k)

Reduce Meals Service Saving from 93k to 52k (reduction of 41k)

Reduce Delayed Utilisation of Reinvestment Funding from 500k to 400k (reduction of 100k)

Total Reduced Savings: 616k.

X FINANCIAL MONITORING POSITION AS AT 31ST MARCH, 2021

There was submitted Report No DIJB31-2021 by the Chief Finance Officer providing an update of the year end financial monitoring position for delegated health and social care services for 2020/2021, including an overview of the costs and financial risks associated with Dundee Health and Social Care Partnerships response to the COVID-19 crisis.

The Integration Joint Board agreed:-

(i) to note the content of the report including the overall actual financial position for delegated services to the 2020/2021 financial year end as at 31st March, 2021, as outlined in Appendices 1, 2, 3 and 4 of the report;

(ii) to note the costs associated with Dundee Health and Social Care Partnerships response to the COVID-19 crisis as set out in section 4.5 of the report; and

(iii) to note the year end reserves position as set out in section 4.6 of the report.

Following questions and answers the Integration Joint Board further agreed:-

(iv) to note the request by Donald McPherson for information on Dundee City Council Older Peoples Services to be provided in the report to assist understanding and that the Chief Finance Officer would arrange for the report for submission to the August meeting to be more detailed so as to provide greater clarity and explanation in relation to figures mentioned;

(v) to note, following enquiry from Bailie Helen Wright in relation to prescribing, the explanation of the Chief Finance Officer in relation to the underspend and that prescribing costs were managed on a national basis and the propriety of the prescribing process in place in the interests of patient safety and that, in addition, he would take up Bailie Wrights question in relation to use of bubble pack medicines and the effect any change of a particular drug contained would have on the continued use of that pack with relevant officers and get back to her directly on the matter;

(vi) to note the observation of the Staff Partnership Representative in relation to savings in the Learning and Disability Service and his request for assurance that people were getting the service they required, and the explanation of the Chief Social Work Officer that this saving was more to do with the recruitment of staff and that she would provide him with more detail on this outwith the meeting; and

(vii) to note the view of Trudy McLeay that there could be more of a focus made on social prescribing to support the population.

XI UNAUDITED ANNUAL ACCOUNTS 2020/2021

There was submitted Report No DIJB32-2021 by the Chief Finance Officer presenting the Integration Joint Boards Unaudited Annual Statement of Accounts 2020/21.

The Integration Joint Board agreed:-

(i) to approve the content of the Unaudited 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 Boards Unaudited Annual Statement of Accounts 2020/21 as outlined in Appendix 3 of the report; and

(iv) to instruct the Chief Finance Officer to submit the Unaudited Accounts to the Integration Joint Boards external auditors (Audit Scotland) by the 30th June, 2021 to enable the audit process to commence.

Following questions and answers the Integration Joint Board further agreed:-

(v) to note the observation of Anne Buchanan that Dundee had the highest proportion of adults with learning disabilities in Scotland and the explanation, provided by Trudy McLeay, that her understanding was that this was recognition of the standard of support provided and people moving in to the area to take up that support;

(vi) to note, as advised by Trudy McLeay, that the vacancy on the Integration Joint Board for a Registered General Medical Practitioner whose name was on the list of primary medical performers may be filled in July 2021;

(vii) to note, as indicated by Trudy McLeay, the importance of attendance at meetings of the Integration Joint Board by medical professionals and, in particular, their contribution to decisions as the country was moving from the lockdown period and that the Chairperson, Councillor Ken Lynn would contact NHS Tayside with a view to securing more regular attendance at meetings;

(viii) to note, as indicated by the Service User Representative, that separate to her membership of the Integration Joint Board that she had been invited to attend a meeting of the Dental Executives Group in Dundee; and

(ix) to note, as indicated by the Chief Finance Officer that Page 71 of the report would be amended to reflect that Martyn Sloan who served on the Integration Joint Board as the Person proving unpaid care in the area of the local authority was not a representative from Dundee Carers Centre.

XII ANNUAL INTERNAL AUDIT REPORT 2020/2021

There was submitted Report No DIJB33-2021 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 2020/2021.

The Integration Joint Board agreed:-

(i) to note the content and findings of the Annual Internal Audit Report 2020/2021 as outlined in Appendix 1 of the report; and

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

Following questions and answers the Integration Joint Board agreed:-

(iii) to note, following enquiry from Bailie Helen Wright the explanation of the Chief Internal Auditor as to what was meant by weaknesses; and

(iv) to note the observation of Donald McPherson for the opportunity for a common approach to deal with matters and any other areas along the same approach as that undertaken for Risk Management across a Tayside perspective.

XIII STANDING ORDERS AMENDMENT

There was submitted Agenda Note No DIJB35-2021 reporting that as meetings of the Integration Joint Board and the Performance and Audit Committee were now being held at 10.00 am, it was recommended that the Integration Joint Board agreed that the Clerk be remitted to make amendment to the Standing Orders accordingly and that Section 15.1 relative to Procedure for Motions and Amendments be amended to reflect that all motions and amendments should be submitted in writing to the Clerk to the Integration Joint Board on or before 12 noon on the day before the meeting.

The Integration Joint Board agreed that the Standing Orders be amended as indicated.

XIV MEETINGS OF THE INTEGRATION JOINT BOARD 2021 ATTENDANCES

There was submitted a copy of the attendance return Report No DIJB34-2021 for meetings of the Integration Joint Board held to date over 2021.

The Integration Joint Board agreed to note the content of the document.

XV DATE OF NEXT MEETING

The Integration Joint Board agreed to note that the next meeting of the Integration Joint Board would be held remotely on Wednesday 25th August, 2021 at 10.00 am.

Ken LYNN, Chairperson.