Dundee City Health & Social Care Integration Joint Board - 25/08/2021

At a MEETING of the DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held remotely on 25th August, 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 23rd June, 2021 was submitted and approved.

IV SUICIDE PREVENTION STRATEGIC UPDATE

There was submitted Report No DIJB37-2021 by the Chief Officer giving an overview of the strategic suicide prevention arrangements in Dundee and collaborative developments across Tayside.

The Integration Joint Board agreed:-

(i) to note the content of the report;

(ii) to remit to the Chief Officer to submit a report to a future Integration Joint Board meeting regarding the outcomes of the suicide prevention stakeholder event planned for November 2021 as outlined in section 4.3.4 of the report;

(iii) to remit to the Chief Officer to submit the draft Dundee Suicide Prevention Strategic and Commissioning Plan for approval once this has been refreshed as outlined in section 4.3.5 of the report;

(iv) to remit to the Chief Officer to submit the draft Tayside Suicide Prevention Action Plan 2021/2024 for approval once this had been finalised as outlined in section 4.3.5 of the report; and

(v) to note the publication of the toolkit to support the development of local area Suicide Prevention Action Plans as outlined in Appendix 1 of the report.

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

(vi) to note the observation of Bailie Wright in relation to the age profiling mentioned in the report and that this may relate to the same generation of people in terms of demographics and for this to be examined;

(vii) to note the request of Bailie Wright for information on suicide trends over the COVID Pandemic period to be provided should they become available;

(viii) to note following enquiry from Trudy McLeay in relation to support for students and also financial support for families and direction to services in times of stress such as the Listening Service the advice of Arlene Mitchell that the Partnership were confident that appropriate support was in place at Universities in Dundee and that the Listening Service provided positive support towards the aims of the Community Health and Wellbeing Hub and that she would make further enquiry in relation to bereavement support for families and reply back to Trudy McLeay on this;

(ix) to note following enquiry from Trudy McLeay in relation to the possible provision of a Listening Service in the Hub the advice of Arlene Mitchell that it was still to be decided which services would be placed in the Hub; and

(x) to note following enquiry from Donald McPherson on support for families of individuals who had attempted suicide the advice of Arlene Mitchell that the Partnership continued to examine support mechanisms for families who had experienced suicide or attempted suicide and awareness of how this may further affect other members within that family circle.

V CARERS INVESTMENT PLAN UPDATE

Reference was made to Article VIII of the minute of meeting of this Integration Joint Board held on 21st April, 2021, wherein the report on engagement work carried out by the Partnership in relation to the impact COVID-19 on unpaid Carers in the City was agreed.

There was submitted Report No DIJB38-2021 by the Chief Finance Officer providing an update in relation to work undertaken by the Carers Partnership and seeking approval of the updated Carers (Scotland) Act Investment Plan 2021/2022 and noting the anticipated allocations for 2022/2023.

The Integration Joint Board agreed:-

(i) to note the work undertaken by the Carers Partnership to develop investment plans as described in the report;

(ii) to approve the Carers (Scotland) 2016 Act Investment Plan 2021/2022 set out in Appendix 1 of the report which included anticipated allocations for 2022/2023;

(iii) to accept the risk level described in section 6 of the report; and

(iv) to remit to the Chief Officer to issue the Directions set out in section 8 of the report.

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

(v) to note the observation of Martyn Sloan on the benefit of more detail on what was to be provided through the Investment Plan and that Dave Berry would look to issue the Integration Joint Board with more information in this regard such as staffing matters;

(vi) to note following enquiry from Councillor Lynne Short that any evaluation of the projects in terms of the Carers Act would be reported to the Performance and Audit Committee;

(vii) to note following enquiry from Councillor Short the advice of Jenny Hill that work was ongoing to help people identify themselves as being Carers; and

(viii) to note the observation of Anne Buchanan in relation to the benefits of care being provided on an over night basis.

VI REVISION OF DUNDEE HEALTH AND SOCIAL CARE INTEGRATION SCHEME

There was submitted Agenda Note DIJB39-2021 advising that in December 2020 the Integration Joint Board was informed that NHS Tayside and Dundee City Council had completed the statutory review of the Dundee Health and Social Care Integration Scheme (required by section 44 of the Public Bodies (Joint Working) Scotland Act 2014) and had agreed that a revised scheme should be prepared (Article X of the minute of the meeting of the Dundee Integration Joint Board held on 15th December 2020 refers). The report provided to the Integration Joint Board at that time set out the intended approach to the preparation of a revised scheme and committed to providing an update on progress no later than 31st March, 2021.

It was reported that the work to progress the production of a revised scheme had progressed more slowly than had originally been intended. In part this was due to the second wave of the pandemic at the beginning of 2021. However, additional time was also taken to clarify, through the Tayside Joint-Chief Executives Group, the scale and scope of the revision work in order that this could be progressed through a joint approach across all Tayside partners (corporate bodies and Integration Joint Boards).

The following key areas of progress had been achieved:

- A Principal Officer from Angus Health and Social Care Partnership had been seconded to project manage the revision process.

- An Integration Project Group had been established with representation from each Council, NHS Tayside and each Health and Social Care Partnership across Tayside and had been meeting regularly since April 2021. The Chief Finance Officer and Service Manager, Strategy and Performance were representing the Dundee Health and Social Care Partnership on this group.

- A Project Initiation Document (PID) had been agreed through the Tayside joint-Chief Executives Group following consultation with the Integration Joint Boards Chief Officers. This sets out how partners wouldl work together to revise the schemes across Tayside including the aims of the project, drivers for change, project scope, roles and responsibilities of stakeholders, outline timescales, project reporting and risks to project delivery.

- The Principal Officer had undertaken a review of integration schemes in place across Scotland, with particular attention to the small number of schemes that had recently been revised following the completion of the statutory review in other Partnerships.

- The Principal Officer had begun the process of compiling discussion documents to support stakeholder engagement in the re-drafting of scheme text for sections of the scheme identified as priorities for revision through the Tayside joint-Chief Executive Group.

The Principal Officer leading the project would work with the Chief Finance Officer and Service Manager, Strategy and Performance to provide quarterly updates to the Integration Joint Board members through appropriate local reporting and communication routes (including further formal reports to the Integration Joint Board where this was required at key points in the revision process). The target for full project completion, including submission to the Scottish Government for parliamentary approval of the revised scheme, remained March 2022.

The Integration Joint Board agreed to note the updated position.

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

(i) to note following enquiry from Donald McPherson in relation to whistle blowing mechanisms to be incorporated that Dave Berry would feed in his comments to the Project Team for consideration.

VII DUNDEE PRIMARY CARE IMPROVEMENT PLAN UPDATE

There was submitted Report No DIJB40-2021 by the Chief Officer providing an update on the implementation of the Dundee Primary Care Improvement Plan for 2020/2021 and seeking approval for the implementation of the Dundee Primary Care Improvement Plan for 2021/2022.

The Integration Joint Board agreed:-

(i) to note the progress to implement the Dundee Primary Care Improvement Plan 2020/2021 in the third year of delivery as outlined in Appendix 1 of the report and the key achievements as described in section 4.3.3 of the report;

(ii) to approve the proposed actions for Dundee Health and Social Care Partnership for 2021/2022 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 note that aspects of the Plan would not be fully implemented by March 2022, and that practices would receive transitionary payments after that time point for services they were still delivering as outlined in section 4 of the report;

(iv) to instruct the Chief Officer to issue Directions to NHS Tayside to implement the specific actions relevant to them as outlined in Appendix 1 of the report;

(v) to note the previous agreement to delegate the monitoring of the Dundee allocation of the Primary Care Improvement Fund as noted in section 3.6 of the report; and

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

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

(vii) to note the advice of Dr David Shaw following enquiry from Councillor Short that the use of premises was being investigated as part of a wider property strategy in light of learning over the COVID period and that public health had been in discussion with regard to the use of retail premises; and

(viii) to note that Dr David Shaw would make the Team aware of point raised by Trudy McLeay in relation to telephone contact being made with any service user to confirm whether they still required that service in light of any extended time period between referral and appointment and the possibility of the patient being directed to another service area for help should demand outweigh availability.

VIII MENTAL HEALTH AND WELLBEING STRATEGIC UPDATE

There was submitted Report No DIJB41-2021 by the Chief Officer providing a briefing about local and Tayside strategic mental health and wellbeing developments.

The Integration Joint Board agreed:-

(i) to note the contents of the report;

(ii) to remit to the Chief Officer to present a report outlining the outcome of the review of Dundee Mental Health and Wellbeing Strategic Plan to the meeting of the Integration Joint Board to be held in October 2021; and

(iii) to approve a funding contribution of 180k per annum from delegated mental health funding as Dundees contribution towards implementing Distress Brief Intervention as set out in section 4.13 of the report.

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

(iv) to note following enquiry from Councillor Lynn the advice of Arlene Mitchell that a Stakeholder Group would be set up for the establishment of the Community Wellbeing Centre and that a consultation paper had ben drawn up for engagement with Stakeholders and that the design of the building was expected to be as inclusive as possible to provide a service for a range of people and age groups across the city.

IX FINANCIAL MONITORING POSITION AS AT JUNE 2021

There was submitted Report No DIJB42-2021 by the Chief Finance Officer providing an update of the projected financial monitoring position for delegated health and social care services for 2021/2022, 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 projected financial position for delegated services to the 2021/2022 financial year end as at 30th June 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 that officers within the Health and Social Care Partnership would continue to carefully monitor expenditure and develop a range of actions to mitigate any overspend.

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

(iv) to note that Dave Berry would refine the content of the report for next meeting in relation to explanation of underspends and overspends following enquiry from Bailie Helen Wright in relation to impact of COVID; and

(v) to note the observation of Donald McPherson for transformation opportunities to be explored when possible and for Risks in terms of the Risk Assessment findings to be minimised as far as possible and the reply from Dave Berry that a lot of change had taken place in services and that further information would be brought froward on any services which required to be financed and that risk levels reflected the current uncertainty of public sector finance.

X ALCOHOL AND DRUG PARTNERSHIP SELF- ASSESSMENT FINDINGS

There was submitted Report No DIJB43-2021 by the Chief Officer informing of the findings of the Alcohol and Drug Partnerships self-assessment process undertaken between May and July 2021 to evidence and evaluate the Dundee Partnerships performance in implementing the Action Plan for Change and addressing the 16 recommendations made by the Dundee Drug Commission in 2019.

The Integration Joint Board agreed:-

(i) to note the contents of the report, including the overview of the self-assessment process undertaken between May and July 2021, and findings of the self-assessment as outlined in section 4.4 and 4.5 of the report and Appendix 1 of the report;

(ii) to note that the self-assessment report had been submitted to the Dundee Drugs Commission to support their work to independently evaluate progress towards implementation of the recommendations made by them in 2019 as outlined in section 4.6.1of the report;

(iii) to note that amendments would be made to the Action Plan for Change based on the self-assessment findings as outlined in section 4.6.2 and instruct the Chief Officer to submit the revised plan to the Integration Joint Board for information once it had been agreed by the Dundee Partnership;

(iv) to note the additional funds provided by Dundee City Council and the Scottish Government and planned investment to support and accelerate actions contained within the Action Plan for Change as outlined in section 4.7 of the report; and

(v) to seek additional opportunities to increase funding from both local and national sources, in order to progress the revised action plan and to address developing service requirements.

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

(vi) to note the enquiry from Councillor Ken Lynn about capacity to develop further bids for monies and that advice of Diane McCulloch that the Partnership had a officer in post who carried out this work; and

(vii) to note following enquiry from Councillor Lynne Short in relation to the process of Cora funding and use of Fort by Alcohol and Dru Partnership the advice of Kathryn Sharp that Fort was embedded within the Children and Families Service of Dundee City Council and that possibility of this process being used within Adult Services would be examined.

XI ANGUS AND DUNDEE STROKE REHABILITATION PATHWAY REVISION

There was submitted Report No DIJB44-2021 by the Chief Officer reporting on the outcomes of the review of hyperacute and acute stroke care pathway as part of the Angus and Dundee Health and Social Care Partnerships respective redesign programmes.

The Integration Joint Board agreed:-

(i) to note the work to date to progress the development of stroke rehabilitation pathway review;

(ii) to support and approve the preferred model of care as outlined in the report;

(iii) to request a detailed implementation plan was brought back to Dundee Integration Joint Board; and

(iv) to remit the Chief Officer to issue Directions as outlined in section 13.1 of the report.

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

(v) to the content of the Direction to be issued being adjusted to include provision of non financial monitoring under Performance and Monitoring to reflect how the service was performing; and

(vi) to note the observation of Councillor Lynne Short that with the proposed service involving both Angus and Dundee that there would have been benefit to having information on the Angus position contained within the Integrated Impact Assessment Report which was attached to the report.

XII A NATIONAL CARE SERVICE FOR SCOTLAND - CONSULTATION

There was submitted Agenda Note DIJB45-2021 advising that the Independent Review of Adult Social Care recommended the creation of a National Care Service, with Scottish Ministers being accountable for adult social care support. The First Minister set out a commitment to start formal consultation for the new National Care Service in the first 100 days of the Parliament with a view to introducing legislation in the first year of the Parliament. However, the Scottish Governments ambition was to go beyond that. This consultation therefore would seek views on creating a comprehensive community health and social care service that supported people of all ages. It was focused on exploring the suggestions for significant cultural and system change that would need to be supported by primary legislation, new law, and to ensure the governance and accountability across the system to deliver successfully for people.

The Scottish Government were proposing that the National Care Service would define the strategic direction and quality standards for community health and social care in Scotland. It wouldl have local delivery boards which worked with the NHS, local authorities, and the third and independent sectors to plan, commission and deliver the support and services that the people of Scotland required.

The proposals would also take forward recommendations of the Independent Review of Adult Social Care around:

- ensuring that care was person-centred and human rights based

- providing greater recognition and support for unpaid carers

- improving conditions for the workforce

- commissioning for public good, and

- more effective approaches to scrutiny and improvement of social care services.

The consultation was divided into the following themes:

- Improving care for people

- The scope of the National Care Service

- Community Health and Social Care Boards

- Commissioning of services

- Regulation

- Fair work and valuing the workforce

The Consultation would run from 9th August, 2021 until 18th October.

Organisations were asked to promote the consultation widely within local networks and to support people with lived and living experience to engage with the consultation in a meaningful way.

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

Following questions and answers the Integration Joint Board further agreed to note that a Briefing Session on the consultation would be held in September 2021 for the membership of the Integration Joint Board.

XIII MEETINGS OF THE INTEGRATION JOINT BOARD 2021 ATTENDANCES

There was submitted a copy of the attendance return Report No DIJB46-2021 for meetings of the Integration Joint Board held to date over 2021.

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

XIV 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 27th October, 2021 at 10.00 am.

Ken LYNN, Chairperson.