Agenda and minutes

The Chair asked for Declarations of Interest. No interests were declared.

Statement on Equalities:

(1)       Consider, and if so decided, adopt:- “In line with the Joint Board’s legal  duty under section 149 of the Equality Act 2010 the Joint Board, in making decisions on the attached reports, shall have due regard to the need to”:-

(i)                 eliminate discrimination, harassment and victimisation;

(ii)               advance equality of opportunity between those who share a protected characteristic and persons who do not share it; and

(iii)              foster good relations between those who share a protected characteristic and persons who do not share it; and

(2)       where an integrated impact assessment has been provided, to take its contents into consideration when reaching a decision.

In taking decisions on the undernoted items of business, the Committee agreed, in terms of Section 149 of the Equality Act 2010:-

(1)       To have due regard to the need to:-

(a)  eliminate discrimination, harassment and victimisation;

(b)  advance equality and opportunity between those who share a protected characteristic and persons who do not share it; and

(c)  foster good relations between those who share a protected characteristic and persons who do not share it, and

(2)       to consider, where an Integrated Impact Assessment has been provided, its contents and to take those into consideration when reaching a decision.

          Consider and, if so decided, adopt the following resolution:

       “That under paragraphs 2, 3, 6 and 7 of the Categories of Exempt Information, found at Appendix 2 of the Standing Orders of the Integration Joint Board, the public and media representatives be excluded from the meeting for Items 16, 17 and 18 of the business below, on the grounds that it involves the likely disclosure of exempt information of the classes described in the relevant paragraphs.

The Joint Board agreed, that under paragraphs 2, 3, 6 and 7 of the Categories of Exempt Information, found at Appendix 2 of the Standing Orders of the Integration Joint Board, the public and media representatives be excluded from the meeting for Items 16, 17 and 18 of the business below, on the grounds that it involves the likely disclosure of exempt information of the classes described in the relevant paragraphs.

There had been circulated and was approved as a correct record the Minute of the Meeting of 5 July 2023, subject to an amendment to item 7A – change word from ‘monitor’ to ‘manage’ and addition of – (d) the need for savings to be identified by September/October 2023 in order to allow execution before the start of the new financial year.

There had been circulated and was noted a report by the Chief Officer providing updates on progress with actions which had still to be completed and advising when these were scheduled to be reported to the Joint Board.

There had been circulated a report by the Chief Officer, providing an update of the ongoing work of the Health and Social Care Partnership, including updates on (1) an ongoing condition survey of Aberdeenshire Council and NHS Grampian properties built with Reinforced Autoclaved Aerated Concrete (RAAC); (2) officer participation in an engagement exercise on a Place Strategy; (3) the National Care Homes Contract (NCHC) and local review: (4) the Aberdeenshire Certificate of Eligibility for Specialist Registration (CESR) recruitment; (5) a forthcoming Prison-Based Social Work Review by the Care Inspectorate and HM Inspectorate of Prisons for Scotland; (6) a recent workshop to review elements of the management of delayed discharges: and (7) progress of the National Care Service (NCS) Bill.

By way of update, the Chief Officer advised that work was underway to identify any properties used by the H&SCP in Aberdeenshire that may contain RAAC and surveys were being arranged to assist in determining any required actions; proposals to bring a report to the IJB on consultations on a Place Strategy; noted that in relation to the National Care Homes Contract, monitoring continued and work had been commenced on an assessment/appraisal of the care home sector across Aberdeenshire; development of a CESR fellowship programme in Aberdeenshire which had resulted in the recruitment to a number of posts in Adult Mental Health; noted that work had commenced on a joint thematic review of Prison-Based Social Work across Scotland and work had begun, and a working group established to support the work of the review at HMP Prison Peterhead; noted that an away day had taken place for around 100 practitioners to review elements of the management of delayed discharges, which focussed on improving the pathway from hospital to home, and an action plan would be collated from the findings of the workshop; noted that the National Care Service (NCS) Bill was still at Stage 1 of the parliamentary process and a first Parliamentary vote on the Bill was not expected until January 2024.

After discussion, the Integration Joint Board agreed:

(1)          with regard to delayed discharge, that a summary of the barriers and challenges of managing delayed discharges identified at the workshop event should be provided to the IJB when the findings of the workshop had been collated;

(2)          to note that winter planning communications would be issued jointly across the three IJBs and Health Board to ensure consistency and clarity of messaging;

(3)          that the Chief Officer would report back to the next meeting of the IJB on Winter Plan arrangements, with multi-agency, cross service input; and

(4)           to note the terms of the updates provided.

There had been circulated a report dated 9 August, 2023 by the Chief Finance and Business Officer, providing an update on the first financial monitoring information for the 2023/24 financial year, which covered the three month period up to the end of June 2023.

The Chief Finance and Business Officer provided an overview of the financial position as at end June 2023, the detailed position by service area, highlighted the areas which recorded the largest over budget positions and the largest underspends as at the end of June 2023, and the budget virements proposed for approval, as contained in Appendix 3 of the report. He also provided a forecast for the year based on the June results, which showed a forecast overspend at the end of June 2023 for 2023/24 of £11.4 million, with forecast reserve balance of £3.8 million reducing the overall pressure to £7.6 million. He advised that a review of the areas of material overspend and mitigations to reduce predicted overspend position was ongoing, along with recovery planning. He advised that meetings had been arranged with the Senior Leadership Team, the Chief Finance and Business Officer, Finance managers from both partnership organisations to review in detail the Quarter 1 position and the impact on 2023/24 and beyond. Work was ongoing to identify trends and areas of potential mitigation.

During discussion, Members commented on the following:

(a)          the ongoing challenges relating to recruitment and knock on effects on service delivery, reflected in a current under budget spend on Older People – Home Care and ongoing recruitment initiatives to address the recruitment challenges;

(b)          noted that the Senior Leadership Team and all budget holders were working closely to address the very significant budgetary challenges and to address ongoing and new emerging cost pressures;

(c)          the need to control the projected overspend within existing budgets was critical;

(d)          noted that a Recovery Working Group had been formed at a meeting of IJB Finance Officers to support the work of IJBs across Scotland in addressing the savings being sought by all IJBs due to the current financial pressures;

(e)          for the purposes of scrutiny, it was important to understand how much of the total budget was within the control of the IJB and how much was spend that the IJB did not have direct control over;

(f)            noted that in para 10.1 of the report the IJB had agreed to review and update the MTFS to reflect the ongoing transformation of services and this would be reflected in future budget considerations.

After further consideration of the report, the Integration Joint Board agreed:

(1)            to note the financial position set out in the report and Appendices 1 and 2;

(2)            to approve the budget adjustments detailed in Appendix 3;

(3)            that a briefing note be issued before the next meeting on the proposed budget allocations for Mental Health, ADP and Primary Care;

(4)            to note that a development session was scheduled for 25 August 2023 to consider budgetary position and underlying pressures;  ...  view the full minutes text for item 6.

There had been circulated a report dated 9 August, 2023 by the Chief Finance and Business Officer providing a summary of issues discussed at the recent meeting of the IJB Audit Committee on 5 July, 2023, including (a) the outcome of completed audits in respect of Adults with Incapacity, Day Care Establishments and Criminal Justice; (b) the Internal Audit Annual Report 2022/23; (c) the External Audit Plan 2022/23; (d) an update on the unaudited Annual Accounts for 2022/23; (e) an update on the work of the Risk Assurance Group and Risk Register.

The Chair of the IJB Audit Committee provided an overview of the work that was underway and reiterated that a lot of work was underway to address the audit recommendations, with strong ownership across the whole of the Health and Social Care Partnership to drive forward the necessary work to ensure that actions were closed off in a timely fashion. She hoped that the IJB could take assurance from the work that was underway.

During discussion, Members commented on the development of an assurance framework and noted that a development session would be scheduled to progress the recommendations; noted that good progress was being made in addressing the audit recommendations, which would give a good foundation to move forward.

After discussion, the Integration Joint Board agreed:

(1)           to note that good progress had been made with addressing the audit recommendations and to note the work ongoing to strengthen the governance processes and continuous improvement, supported by the Interim Strategic Governance Review Manager; and

(2)           to note the key points and assurances from the IJB Audit Committee in relation to audit matters.

There had been circulated a report dated 28 July, 2023 by the Chief Officer advising of a proposed review of the Governance Handbook of the IJB which was adopted in March 2022. The report advised that there was currently a focussed project to strengthen the governance arrangements of the IJB and a review of the Governance Handbook formed part of that project. An assurance framework was also being develop which, though initially for the Audit Committee, may be something that the IJB and all its Committees may wish to use and incorporate into the Governance Handbook, under a scrutiny section.

The Interim Strategic Governance Review Manager highlighted the areas of work that were being undertaken to strengthen the governance arrangements of the IJB and highlighted that engagement with key stakeholders within the partnership would be crucial in reviewing the governance arrangements to identify improvements to the Governance Handbook. In addition, she proposed a refresh of the membership provisions, to ensure they were fit for purpose, and following this a report to the IJB with any proposed changes to the Governance Handbook would be presented, with a timescale of end of 2023 at the latest.

During discussion, members welcomed the proposals for the review; suggested consideration of the addition of a local third sector interface to the membership, to allow greater access to all of the third sector organisations; suggested further consideration of funding mechanisms to assist non-voting members to allow them to attend meetings; and noted some minor corrections to the date of appointment of members.

After discussion, the Integration Joint Board agreed:

(1)            to note the commencement of a review of the Governance Handbook;

(2)            to note, for clarification, the commencement date of term for Mr Steven Lindsay of 1 September, 2022;

(3)           to agree to initiate a review the membership of the IJB; and

(4)           to note that a further report to the IJB on the review would be presented by the end of 2023.

There had been circulated a report dated 26 July, 2023 by the Chief Officer seeking consideration of a strategic partnership agreement with Public Health Scotland (PHS) on behalf of the Aberdeenshire Health and Social Care Partnership, as one of nine organisations comprising the North East Population Health Alliance (NEPHA). The report advised that the aim and purpose of the strategic partnership agreement was to develop a learning system to improve population health and reduce health inequalities across the North East of Scotland. The draft agreement outlined a shared vision, value of the partnership, how the organisations would work together within the remit of the agreement, and high-level objectives which provided an indication of areas the agreement would focus on.

During consideration of the proposed draft strategic partnership agreement, Members commented on a number of points, including:

a)    the challenges in bringing together multiple organisations to work together on a shared vision, and the potential impacts upon staff;

b)    the need to avoid confusion within communities and to ensure no duplication with existing community planning initiatives;

c)    noted opportunities for shared learning;

d)    questioned the arrangements for secondment opportunities and any potential impacts or consequences;

e)    noted that any work undertaken by the alliance would be driven by the constituent partners;

f)      the need for a development session on population health to explore further the issues and challenges in respect of the proposed strategic partnership.

After discussion, the Integration Joint Board agreed:

(1)          that the draft agreement should clarify that NEPHA is a  vehicle for collaboration on the population health agenda and the relationship between NEPHA and the governance structures is that:

a.       Priorities for population health sit within the respective decisions captured in plans and strategies of the governance bodies (including each IJB);

b.       NEPHA provides a network which the executives of the partner bodies can use to derive wider benefits by collaborating and learning when taking forward those priorities as established by the governance bodies;

c.       The work programme of NEPHA (and so too the Strategic Agreement with PHS)  therefore has a direct link to the priorities of the partners, and progress on the work programme will be shared periodically with those governance bodies;

(2)          Following clarification of the significant concerns raised around the impacts and consequences of the existing governance arrangements, and around staffing impacts, data sharing etc, to delegate to the Chief Officer, in consultation with the Chair and Vice-Chair to receive a final draft version of the strategic partnership agreement for sign off; and

(3)          that the Chief Officer should report back to the IJB with a progress report on the strategic partnership agreement in 6 months time.  

There had been circulated a report dated August 2023 by the Chief Officer which asked the IJB to note the priorities set out within the NHS Grampian Three Year Delivery Plan for 2023-2026 and to note the arrangements for reporting on progress of the NHS Grampian Delivery Plan as complementary to existing IJB reporting.

The Joint Board heard from the Planning Manager, Planning, Innovation and Programmes team within NHS Grampian, who outlined the details of the report and highlighted the overarching objectives of the delivery plan, which were linked to the pillars of people, places and pathways, which formed the NHS Grampian strategy ‘Our Plan for the Future’. She indicated that there was coherence between the NHS Grampian Plan for the Future and the Aberdeenshire IJB Strategic Plan, and officers from all three Health and Social Care Partnerships had been closely linked in the development work of the three year delivery plan. She confirmed that progress on the delivery plan would be reported quarterly to Scottish Government, via milestone updates and a set of key performance indicators was being developed as part of the reporting structure to Grampian NHS Board.

The Chief Officer highlighted a number of areas where joint objectives had been agreed, including pathways work, taking a person centred approach; Primary care – addressing significant sustainability issues around GP practices across Aberdeenshire; and the need to consider areas for improvement and learning.

After consideration, the Integration Joint Board agreed:

(1)           to note the priorities set out within the NHS Grampian Three Year Delivery Plan (2023-26) for the period up to March 2026; and

(2)           to note the arrangements for reporting on progress of the NHS Grampian Delivery Plan as complementary to existing IJB reporting. 

There had been circulated a report dated 25 July 2023 by the Chief Officer which asked the Joint Board to approve a draft response to the Health and Care (Staffing) (Scotland) Act 2019 Statutory Guidance Consultation, which was being consulted on by the Scottish Government. The report advised that the draft guidance had been prepared with the involvement of external stakeholders,  including local authorities, and the key aims were to enable safe and high quality care or services through the provision of appropriate staffing. It was important from a Health and Social Care Partnership perspective that the statutory guidance was clear and ensured understanding of the duties placed on the relevant organisations by the Act.

After consideration, the Integration Joint Board agreed to approve the draft response to the Health and Care (Staffing) (Scotland) Act 2019 Statutory Guidance Consultation, as provided in Appendix 1 to the report.

There had been circulated a report dated 31 July 2023 by the Partnership Manager, North outlining progress on delivery of the national Suicide Prevention Strategy, Action Plan and local implementation, and advising that progress updates would be provided annually to the Integration Joint Board.

Members heard from the Partnership Manager, North and the Mental Health and Learning Disability Service Manager, Central, who highlighted the commitment of partnership working and the actions being taken across Aberdeenshire to address the long term outcomes of the national suicide prevention strategy.

There was discussion of work to support young people, including in schools and it was noted that the strategy was a ‘whole life span’ strategy.

After consideration of the report, the Integration Joint Board agreed:

(1)           to note the progress on delivery of the national Suicide Prevention Strategy, Action Plan and local implementation; and

(2)           to note that progress and relevant information would be provided annually to the Integration Joint Board.

There had been circulated a report dated 31 July 2023 by the Partnership Manager, North which asked the IJB to consider the annual report on Community Justice in Aberdeenshire for 2022/23 and highlighting the progress that had been made collectively by the Aberdeenshire Community Justice Partnership during the period.

The Project Manager, Community Justice, introduced the report and highlighted key elements of the report and she highlighted key achievements, including the recruitment and retention of staff, management of workloads, and a positive picture overall in the after effects of the pandemic. She also referred to the multi agency approach that was taken to addressing priorities and welcomed the support of the IJB where appropriate.

There was discussion of the delivery of unpaid work, which was co-ordinated by the Unpaid Work Teams in the North and South of Aberdeenshire and the various activities that were co-ordinated at a local level.

After discussion, the Integration Joint Board agreed to note the Annual Report on Community Justice in Aberdeenshire for 2022/23, highlighting the progress that has been made collectively by the Aberdeenshire Community Justice Partnership during the period.

There had been circulated a report dated 21 July 2023 by the Chief Officer which asked the IJB to acknowledge the response which had been submitted by the Chief Officer, on behalf of the IJB, using delegated authority, and following consultation with the Chair and Vice-Chair.

The IJB noted that the response had provided the opportunity to give feedback on the issues relating to healthcare in rural and remote areas that matter most to people, and support wider community engagement with people living in these areas of Scotland.

After consideration, the Integration Joint Board agreed to acknowledge the response submitted by the Chief Officer exercising delegated authority and following consultation with the Chair and Vice Chair in terms of paragraph 1.3 (z) of Section 2 of the Aberdeenshire Integration Joint Board Governance Handbook.

There had been circulated a report dated 31 July 2023 by the Chief Finance and Business Officer which asked the IJB to note the updated Adult Social Work Assisted Transport Policy which had been reviewed, following its adoption in 2017.

The Service and Development Manager provided some background to the policy which allowed for supported assisted travel to and from social care provision, and had been subject to a recent audit which has recommended that the policy be reviewed. Following a review, the policy had been deemed to be sound, and it was noted that the Council’s Passenger Transport Strategy and associated Passenger Transport Policy Statement was scheduled for review in the coming year and the Assisted Transport Policy would be shared as part of the review.

After discussion, the Integration Joint Board agreed:

(1)           to note the updated Adult Social Work Assisted Transport Policy which had been reviewed in 2023 following approval in 2017; and

(2)           that a policy review date should be added to ensure that a regular review period was in place.

With reference to the Minute of Meeting of the IJB of 24 August, 2023 (Item 14), there had been circulated a report dated 31 July 2023 by the ChiefOfficer providing a progress update on the transfer of the management of the former Balhousie Huntly Care Home to Aberdeenshire Council, and seeking approval for the extension of the funding to deliver the service for up to a further six months.

The IJB heard from the Partnership Manager, South, who provided an update on the work that was ongoing to implement an improvement plan and had fully utilised the expertise of a multi-disciplinary team to address the areas of concern that had been highlighted, and that the quality of care had improved exponentially in the three months since the transfer and the Care Inspectorate had increased the grade following a full inspection in June 2023. Work was underway to secure another provider to take over the home through a procurement process, and to take full advantage of the opportunity and to support with making an informed decision, an options appraisal was being carried out.

After discussion, the Integration Joint Board agreed:

(1)           to note the progress update and improvement in the quality of the care;

(2)           to approve an extension of the funding to deliver the service for 6 months (or less) to April 2024, as detailed within Section 3.5 of the report; and

(3)           to commend the officers and teams within the care home for the ongoing work to ensure the continued safety of the residents.

There had been circulated a report dated 20 July, 2023 by the Chief Finance and Business Officer requesting approval of a direct award for the provision of a prepaid card system for Direct Payments, using the North East Procurement Organisation (NEPO) Framework.

After consideration, the Integration Joint Board agreed:

(1)           to  approve the direct award of a contract to Prepaid Financial Services for 4 years, using the North East Procurement Organisation (NEPO) framework; and

(2)           to direct Aberdeenshire Council to procure the service detailed in the Supplementary   Procurement Plan (Appendix 2) on behalf of the Integration Joint Board.

With reference to the Minute of Meeting of the IJB of 15 June 2023 (Item 16), there had been circulated a report dated 26 July 2023 by the Chief Officer requesting consideration of a Supplementary Procurement Work Plan and two Procurement Approval Forms, and that the IJB directs Aberdeenshire Council to procure, via a tender opportunity, the services detailed within the Supplementary Procurement Work Plan on behalf of the IJB.

The Joint Board heard from the Strategic Procurement Manager as to the details of the proposed works, and he gave his thanks to those members of the IJB who had provided comments and support to the project team when developing the proposals.

After consideration, the Integration Joint Board agreed:

(1)           to note the Supplementary Procurement Work Plan detailed in Appendix 1, and the two Procurement Approval Forms (PAFs) at Appendix 2A and 2B;

(2)           to approve the PAFs for items on the Work Plan which were within the Integration Joint Board’s remit and the value of the matter was over £1,000,000 and note that the item on the Work Plan with a value of £50,000 up to £1,000,000 may be reserved for approval by Aberdeenshire Council’s Communities Committee before the Integration Joint Board’s Direction is implemented;

(3)           to direct Aberdeenshire Council to procure, via a tender opportunity, the services detailed in the Supplementary Procurement Work Plan on behalf of the Integration Joint Board;

(4)           to note that the contract requirements relating to care and support services align with the Integration Joint Board’s Strategic Plan in relation to Outcome 2: People, including those with disabilities or long-term conditions or are frail, can live independently at home or in a homely setting in their community. Additionally, an update on the outcomes from the approved procurements in the report would be included in the Commercial & Procurement Shared Service’s annual report; and

(5)           to give thanks to the members of the IJB who provided feedback and support to the Procurement team project group.