Performance And Audit Committee (integration Joint Board) - 27/09/2023

At a MEETING of the PERFORMANCE AND AUDIT COMMITTEE OF THE DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held remotely on 27th September, 2023.

Present:-

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

Ken LYNN, Chairperson, in the Chair.

I APOLOGIES FOR ABSENCE

II DECLARATION OF INTEREST

There were no declarations of interest.

lll MINUTE OF PREVIOUS MEETING AND ACTION TRACKER

(a) MINUTE

The minute of meeting of the Committee held on 24th May, 2023 was submitted and approved.

Following questions and answers the Committee further agreed:-

(i) to note that the style of minute had changed to incorporate further actions agreed during the meeting.

(b) ACTION TRACKER

There was submitted the Action Tracker, PAC36-2023, for meetings of the Performance and Audit Committee for noting and updating accordingly.

The Committee agreed to note the content of the Action Tracker.

Following questions and answers the Committee further agreed:-

(i) to note that in relation to action 1 (public information on website) a meeting had taken place yesterday and a plan was being worked on;

(ii) to note that in relation to action 2 (further analysis of the position in relation to the figures for the North East area) the timeframe had slipped to March 2024 as resources were now directed to the Adult Support and Protection inspection.

lV MEMBERSHIP PERFORMANCE AND AUDIT COMMITTEE

Reference was made to Article III of the minute of meeting of the Dundee Integration Joint Board of 23rd August, 2023 wherein it was agreed that Donald McPherson be appointed as a Voting Member on the Committee.

The Committee noted the position.

V DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP PERFORMANCE REPORT 2022/2023 QUARTER 4

There was submitted Report No PAC24-2023 by the Chief Finance Officer updating the Performance and Audit Committee on 2022/2023 Quarter 4 performance against the National Health and Wellbeing Indicators and Measuring Performance Under Integration indicators. Data was also provided in relation to Social Care Demand for Care at Home services.

The Committee agreed:-

(i) to note the content of the summary report;

(ii) to note the performance of Dundee Health and Social Care Partnership, at both Dundee and Local Community Planning Partnership (LCPP) levels, against the National Health and Wellbeing Indicators as summarised in Appendix 1 (tables 1, 2 and 3) of the report;

(iii) to note the performance of Dundee Health and Social Care Partnership against the Measuring Performance Under Integration indicators as summarised in Appendix 1 (table 3) of the report; and

(iv) to note the number of people waiting for a social care assessment and care at home package and associated hours of care yet to be provided in Appendix 2 of the report.

Following questions and answers the Committee further agreed:-

(v) that, at the request of the Chair, a report from the Falls Strategy Group would be presented to a future Integration Joint Board meeting;

(vi) to note, in relation to a question from Donald McPherson, that although there was no nationally available information in relation to the indicator - % staff who say they would recommend their workplace as a good place to work it would be useful to have some local information about how staff feel and Jenny Hill would contact the iMatter team;

(vii) to note, that in relation to a question from Raymond Marshall about the baseline year, that there was a statutory duty to report five proceeding financial years and that due to Covid a decision had been made to wait until the start of next financial year to change the baseline year;

(viii) that, at the request of Councillor McHugh, consideration would be given to changing the scale on the chart on page 28 (Number of People Waiting for a Social Care Assessment); and

(ix) to note, in relation to a question from Raymond Marshall around assurances on performance, that a suite of information was being worked on which would give assurances.

VI MENTAL HEALTH SERVICES INDICATORS 2023/2024 QUARTER 1

There was submitted Report No PAC25-2023 by the Chief Finance Officer reporting a suite of measurement relating to the activity of mental health services for scrutiny and assurance.

The Committee agreed:-

(i) to note the content of the report, including current performance against the suite of mental health service indicators (section 6 and appendix 1 of the report);

(ii) to comment on any further areas for development in the content and presentation of the report; and

(iii) to note the operational and strategic supporting narrative in the context of the trends in performance and activity (section 7 of the report).

Following questions and answers the Committee further agreed:-

(iv) to note, that in relation to a question from Councillor McHugh about whether an up to date Engage Dundee survey on mental wellbeing could be carried out, that the Chief Financial Officer would check whether this was possible through the Dundee Partnership; and

(v) to note the additional information provided by Linda Graham during the meeting.

VII DISCHARGE MANAGEMENT PERFORMANCE UPDATE ON COMPLEX AND STANDARD DELAYS

There was submitted Report No PAC26-2023 by the Chief Finance Officer providing an update to the Performance and Audit Committee on Discharge Management performance in Dundee.

The Committee agreed:-

(i) to note the current position in relation to complex delays as outlined in section 5 of the report, standard delays as outlined in section 6 of the report, and discharge without delay as outlined in section 10 of the report; and

(ii) to note the improvement actions planned to respond to areas of pressure as outlined in sections 8 and 10 of the report.

Following questions and answers the Committee further agreed:-

(iii) that consideration would be given to building in information from the weekly local oversight report into future reports to the PAC;

(iv) to note that consideration was being given to developing a proxy suite of indicators on delayed discharge that would be more accessible to the public than the national indicators.

VIII CARE INSPECTORATE GRADINGS REGISTERED CARE HOMES FOR ADULTS/OLDER PEOPLE AND OTHER ADULT SERVICES2022/2023

There was submitted Report No PAC27-2023 by the Chief Finance Officer summarising for the Performance and Audit Committee the gradings awarded by the Care Inspectorate to Dundee registered care homes for adults/older people and other adult services in Dundee for the period 1st April, 2022 to 31st March, 2023.

The Committee agreed:-

(i) to note the changes to the scale and scope of Care Inspectorate led inspections carried out in 2022/2023 during the reporting year (section 4.1 of the report);

(ii) to note the contents of the report and the gradings awarded as detailed in the attached performance report (Appendix 1 of the report) and highlighted in section 4.2 of the report; and

(iii) to note the range of continuous improvement activities progressed during 2022/2023 as described in section 4.3 and Appendix 1 of the report.

Following questions and answers the Committee further agreed:-

(iv) that consideration would be given to arranging a presentation from the Care Inspectorate to a future Integration Joint Board meeting.

IX REVIEW OF EMERGENCY ADMISSION RATES

There was submitted Report No PAC28-2023 by the Chief Finance Officer providing an update regarding focused analytical work to interrogate and enhance understanding of National Indicator 14 (rate of readmissions to hospital within 28 days of discharge per 1,000 admissions) and associated performance data.

The Committee agreed:-

(i) to note the data presented in the report;

(ii) to discuss the steps taken to review performance; and

(iii) that a summary report would be brought to the next meeting explaining why the issue mattered to the PAC, what the data tells us and what needs to be done in response.

X DRUG AND ALCOHOL SERVICES INDICATORS 2022/2023 QUARTER 4

There was submitted Report No PAC29-2023 by the Chief Finance Officer updating the Performance and Audit Committee on the performance of Drug and Alcohol Services.

The Committee agreed:-

(i) to note the data presented in the report, including the improvements in key indicators relating to access to drug treatment services during 2022/2023 (section 6 and appendix 1 of the report); and

(ii) to note the range of ongoing improvement activity, including within Dundee Drug and Alcohol Recovery Service, Primary Care and Partnership Mental Health Services focused on implementation of Medication Assisted Treatment Standards and wider priorities agreed via the Alcohol and Drug Partnership Strategic Framework and Delivery Plan (section 7 of the report).

Following questions and answers the Committee further agreed:-

(iii) that there may have been an error in the report at paragraph 6.9 and that this would be checked and amended if necessary.

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

There was submitted Report No PAC30-2023 by the Clinical Director providing assurance to Committee on the business of Dundee Health and Social Care Partnership Clinical, Care and Professional Governance Group.

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 report on, 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 and therefore the level of assurance regards clinical and care governance within the Partnership. The timescale for the data within the report was to 31st May 2023.

The Committee agreed:-

(i) to note the Exception Report for the Dundee Health & Social Care Partnership Clinical, Care & Professional Governance Group as detailed from Section 4 of the report; and

(ii) that the level of assurance was reasonable due to the factors as indicated.

Following questions and answers the Committee further agreed:-

(iii) to note that all risks were to be reviewed.

XII DUNDEE INTEGRATION JOINT BOARD INTERNAL AUDIT PLAN PROGRESS REPORT

There was submitted Report No PAC37-2023 by the Chief Finance Officer providing the Performance and Audit Committee with an update on progress against previous internal audit plans as well as work relating to 2023/2024. The report also included internal audit reports that were commissioned by the partner Audit and Risk Committees, where the outputs were considered relevant for assurance purposes to Dundee Integration Joint Board.

The Committee agreed to note the progress of outstanding internal audit reviews and progress against the 2023/2024 internal audit plan.

XIII INTERNAL AUDIT ANNUAL PLAN 2023/2024

There was submitted Report No PAC31-2023 by the Chief Finance Officer seeking approval of the Annual Internal Audit Plan for Dundee City Integration Joint Board (IJB) for 2023/2024, to present the Internal Audit Charter, and to agree the appointment of the Chief Internal Auditor.

The Committee agreed:-

(i) to the continuation of Fife, Tayside and Forth Valley Audit and Management Services (FTF) as the IJBs lead internal auditors and therefore continuing the role of Chief Internal Auditor;

(ii) to approve the 2023/2024 Internal Audit Annual Plan as set out in Appendix 1 to the report; and

(iii) to note there were no changes to the Internal Audit Charter as set out in section 4.2 of the report.

XIV DUNDEE INTEGRATION JOINT BOARD INTERNAL AUDIT REPORT VIABILITY OF EXTERNAL PROVIDERS

There was submitted Report No PAC32-2023 by the Chief Finance Officer presenting the findings of the Internal Audit Review of arrangements in place to monitor the financial viability and operational sustainability of external care providers.

The Committee agreed:-

(i) to note the content and recommendations of the Internal Audit Report on Viability of External Providers as set out in Appendix 1 to the report; and

(ii) to instruct the Chief Finance Officer to implement the recommendations of the report and provide an update on progress to the next meeting of the PAC.

XV QUARTERLY COMPLAINTS PERFORMANCE QUARTER 1

There was submitted Report No PAC34-2023 by the Chief Finance Officer summarising the complaints performance for the Health and Social Care Partnership (HSCP) in the first quarter of 2023/2024. The complaints included complaints handled using the Dundee Health and Social Care Partnership Social Work Complaint Handling Procedure, the NHS Complaint Procedure and the Dundee City Integration Joint Board Complaint Handling Procedure.

The Committee agreed:-

(i) to note the complaints handling performance for health and social work complaints set out within the report; and

(ii) to note the work which had been undertaken to address outstanding complaints within the HSCP and to improve complaints handling, monitoring and reporting.

Following questions and answers the Committee further agreed:-

(iii) to note that the possibility of including information from Care Opinion would continue to be explored.

XVI DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP RISK REGISTER UPDATE

There was submitted Report No PAC35-2023 by the Chief Finance Officer updating the Performance and Audit Committee in relation to the Strategic Risk Register and on strategic risk management activities in Dundee Health and Social Care Partnership.

The Committee agreed:-

(i) to note the content of the Strategic Risk Register Update report;

(ii) to note the extract from the Strategic Risk register attached at Appendix 1 to the report; and

(iii) to note the recent work and future work on Risk Appetite as set out in Section 7 of the report.

XVII GOVERNANCE ACTION PLAN UPDATE

There was submitted Agenda Note PAC33-2023 reporting that at the meeting of the Performance and Audit Committee held on 24th May, 2023, the Internal Audit Review of the Governance Action Plan was considered with the report recommendations agreed to. One of those recommendations was to carry out an exercise, facilitated by Internal Audit to reprioritise outstanding recommendations to ensure completeness of actions with a view to developing separate reporting for Internal Audit Report recommendations, External Audit recommendations, external review recommendations, governance statement improvement actions in addition to actions from agenda item discussions reported within the standard PAC agenda (action tracker).

This work was progressing with a first stage mapping of Internal Audit recommendations almost complete. This work was ongoing and it was proposed that revised reporting in line with the Internal Audit Review be presented to the November PAC meeting. Given the focus of this work, there was no update provided to the existing Governance Action Plan on the current PAC Agenda.

The Committee noted the position.

XVIII ATTENDANCE LIST

There was submitted Agenda Note PAC38-2023 providing attendance returns for meetings of the Performance and Audit Committee held over 2023.

The Committee agreed to note the position as outlined.

XIX DATE OF NEXT MEETING

The Committee agreed to note that the next meeting of the Committee would be held remotely on Wednesday, 22nd November, 2023 at 10.00 am.

Ken LYNN, Chairperson.