Performance And Audit Committee (integration Joint Board) - 31/01/2024

At a MEETING of the PERFORMANCE AND AUDIT COMMITTEE OF THE DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held remotely on 31st January, 2024.

Present:-

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

Donald McPherson, Chairperson, in the Chair.

The Chairperson noted that this would be Dianes last meeting as she was retiring in April and recorded thanks on behalf of the Performance and Audit Committee for the support she had provided

The Chief Finance Officer also noted that it would be Donalds last meeting and recorded thanks for the contribution and support he had provided to the PAC.

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 22nd November, 2023 was submitted and approved.

(b) ACTION TRACKER

There was submitted the Action Tracker, PAC11-2024, 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)                            that action 1 (falls data in relation to the North East) would be closed off as it would be dealt with as part of the Falls Strategy report to the February IJB meeting; and

(ii)                           that in relation to action 6 (review of emergency admission rates), that a short briefing note would be provided in the first instance, with the subject being included in a future development session too.

lV REVISED PAC TERMS OF REFERENCE

There was submitted Report No PAC2-2024 by the Chief Finance Officer informing members of the Committee of the revised Terms of Reference for Dundee Integration Joint Boards Performance and Audit Committee following approval by the Integration Joint Board at its meeting of the 13th December, 2023.

The Committee agreed to note the revised Terms of Reference for the Performance and Audit Committee approved by the Integration Joint Board as attached as Appendix 1 to the report.

Following questions and answers the Committee further agreed:-

(i) that the need to undertake an annual evaluation and develop a formal training programme, that were highlighted by the external auditors as areas of improvement, should be added to the Action Tracker.

V DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP PERFORMANCE REPORT 2023/2024 QUARTER 2

There was submitted Report No PAC4-2024 by the Chief Finance Officer updating the Performance and Audit Committee on 2023/2024 Quarter 2 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);

(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); 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.

Following questions and answers the Committee further agreed:-

(i) that, in relation to a query about the drop in percentage of care services graded good or better, the Inspection Grading Analysis report that had been previously submitted to the PAC would be re-issued;

(ii) that, in relation to a query about Table 1 and the West End showing all red although it was one of the least deprived areas, Lynsey would look into the data and report back; and

(iii) that, in relation to a query about the sudden spike in the number of people waiting for a social care assessment in June 2023, it was likely due to a change in the reporting to the Scottish Government but that this would be checked with colleagues and reported back.

VI DRUG AND ALCOHOL SERVICES INDICATORS 2023/2024 QUARTER 2

There was submitted Report No PAC3-2024 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 2023/2024 (section 6 and appendix 1); and

(ii) to note the range of ongoing improvement activity (section 7).

Following questions and answers the Committee further agreed:-

(iii) to note that MAT Standards benchmarking information was being collated by 12th April, 2024 and would contain much more detail about Standards 6 10; and

(iv) to note that the next Drug and Alcohol Services Indicators report would come to the PAC in around 6 months, after the MAT Standards report had been received.

VII MENTAL HEALTH SERVICES INDICATORS 2023/2024 QUARTER 2

There was submitted Report No PAC5-2024 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).

(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).

Following questions and answers the Committee further agreed:-

(iv) to note that the reference to the Kings Fund review at paragraph 5.7 related to a national, not local, review.

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

There was submitted Report No PAC7-2024 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 30th November, 2023.

The Committee agreed:-

(i) to note the Exception Report for the Dundee Health and 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) that consideration would be given to adding an additional column to show the direction of travel in the table on page 105.

IX DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP STRATEGIC RISK REGISTER UPDATE

There was submitted Report No PAC9-2024 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.

Following questions and answers the Committee further agreed:-

(iv) to note, that in relation to query about reducing the score on the risk regarding the National Care Service, as the risk was about the future of the IJB as an organisation it would remain as a high risk meantime; and

(v) to note, that in relation to a query about whether the risk score should be increased for the risk about restrictions on public sector funding, that the risk score would be reviewed at the appropriate time and may shift for financial year 2024/2025.

X DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP CARE OPINION ROLL- OUT

It was reported that the purpose of the Agenda Note, PAC8-2024, was to provide an overview of the implementation of Care Opinion across the Dundee Health and Social Care Partnership, focusing on: Contract Signing; Service Mapping; Training Sessions; Initial service selection for roll out; Public Communication and Accessibility; and use as a Performance feedback tool.

Contract Signing - the Health and Social Care Partnership successfully signed a contract with Care Opinion in December 2023 for a period of three years, formalising the collaboration for implementing the feedback platform across the partnership.

Mapping of Services - a comprehensive mapping exercise would be conducted to identify all services within the Health and Social Care Partnership. This mapping process would ensure that all relevant services are incorporated into the Care Opinion system for streamlined feedback collection.

Selection of Initial Services - the first wave of services set to use Care Opinion would comprise of those that had prior experience with the platform through the NHS. Leveraging their familiarity would expedite the integration process and encourage initial success stories that could motivate other services to adopt the system. Several teams had expressed a keen interest in using Care Opinion for their feedback.

Regular Training Sessions - ongoing training sessions would be organised for staff at various levels within the Partnership to facilitate the effective use of the Care Opinion platform. These sessions aimed to equip staff members with the necessary skills to navigate the platform, handle feedback, and get the most out of the system.

Publicising Care Opinion and Accessibility - Care Opinion had provided a full suite of information and resources which would be publicised across NHS Tayside and Dundee City Council social media and DHSCP website. As per Dundee City Council and NHS Tayside complaints processes there would be support available to people who want to use Care Opinion but require some assistance to do so online.

Use as a Feedback Tool for Performance - one of the primary objectives of implementing Care Opinion across the Health and Social Care Partnership was to use it as a robust feedback tool for assessing and enhancing performance. The platform would be instrumental in collecting, analysing, and responding to patient and service user feedback, enabling the Partnership to make informed decisions and drive improvements in service delivery.

Conclusion - the implementation of Care Opinion across the Health and Social Care Partnership marked an exciting and significant step toward enhancing feedback mechanisms and leveraging valuable insights for performance improvement. The Partnership remained committed to maximizing the potential of this platform to ensure the delivery of high-quality health and social care services.

The Committee noted the position.

XI GOVERNANCE ACTION PLAN UPDATE

It was reported that the Performance and Audit Committee, PAC12-2024, was advised at its meetings in September and November 2023 that work to develop revised reporting of outstanding Governance Actions previously reported through the Governance Action Plan was ongoing given the complex nature of this work and to ensure there was no duplication of actions. The mapping work for this had now been completed by Internal Audit and the next stage of this process was to enhance and refine the recording of these actions on the Ideagen system (previously known as Pentana). The culmination of this exercise would show a clear link between the source of the required action (Internal Audit Review, External Audit Recommendations, Annual Governance Statement reviews etc), progress made and actions being taken. Furthermore, a protocol was being developed for Internal Audit Actions follow up to ensure these actions were completed timeously in the future. A full overview report would be presented at the May Performance and Audit Committee for consideration.

The Committee noted the position.

XII DUNDEE INTEGRATION JOINT BOARD INTERNAL AUDIT REPORT -OPERATIONAL PLANNING

There was submitted Report No PAC6-2024 by the Chief Finance Officer presenting the findings of the Internal Audit Review of Operational Planning arrangements in place within Dundee Health and Social Care Partnership.

The Committee agreed:-

(i) to note the content and recommendations of the Internal Audit Report on Operational Planning 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 through the internal audit actions reporting process.

XIII DUNDEE INTEGRATION JOINT BOARD INTERNAL AUDIT PLAN PROGRESS REPORT

There was submitted Report No PAC1-2024 by the Chief Finance Officer providing an update on progress against the one remaining review from the 2022/2023 Internal Audit Plan 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 IJB.

Following questions and answers the Committee further agreed:-

(i) to note that a summary would be provided to the next meeting on NHS Taysides Internal Control Evaluation.

XIV ATTENDANCE LIST

There was submitted Agenda Note PAC10-2024 providing attendance returns for meetings of the Performance and Audit Committee held over 2023.

The Committee agreed to note the position as outlined.

XV DATE OF NEXT MEETING

The Committee agreed to note that the next meeting of the Committee would take place remotely on Wednesday, 22nd May, 2024 at 10.00am.

Donald MCPHERSON, Chairperson.