Agenda and minutes

The Chair asked for Declarations of Interest. Susan Webb advised that she had a connection to item 12 by virtue of her role as Executive Lead for Grampian in respect of the Immunisation and Vaccination Programme. However, having applied the objective test she had concluded that she had no interest to declare.

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.

Exempt Information

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

       “That under paragraphs 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 Item 20 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 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 Item 21 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 23 August 2023.

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 an update on (1) the Health, Social Care and Sport Committee Winter Planning 2023-24; and (2) the Health and Care Staffing Act Update.

By way of update, the Chief Officer advised on the key findings from the final report from the Health, Social Care and Sport Committee on Winter Planning 2023/24, on winter preparedness and planning within health and social care. She also advised that in preparation for the implementation of the Health and Social Care Staffing Act Scotland, and Implementation Team had been established within NHS Grampian, which would ensure strong engagement with representation from all relevant staff in scope, clinical professionals and corporate services. From a Social Care perspective, the Care Inspectorate were taking the lead on developing the social care framework.

She advised that the Aberdeenshire Health and Social Care Partnership was very engaged in the process and utilising the Sustainable Workforce Oversight Group to be the central focus for this work.

The Integration Joint Board, after discussion, agreed to note the terms of the updates provided.

There had been circulated a report dated 6 September, 2023 by the Chief Officer requesting consideration of a proposed schedule of meetings for 2024.

The Integration Joint Board agreed to approve the following meeting dates for 2024 –

Wednesday 31 January, 2024;

Wednesday 20 March, 2024;

Wednesday 29 May, 2024;

Wednesday 21 August, 2024;

Wednesday 9 October, 2024;

Wednesday 11 December, 2024.

There had been circulated a report dated 15 September, 2023 by the Chief Officer, advising that IJB member, Ms A Anderson was stepping down from the IJB with effect from 30 November 2023; that NHS Grampian would conduct a recruitment process to appoint a replacement non executive Board Member and voting member of the Aberdeenshire IJB; and asking the IJB to appoint one further member to the IJB Audit Committee and a Chair of that Committee, with effect from 1 December, 2023 to replace Ms Anderson.

Having been advised that the recruitment process to appoint a replacement member for the Aberdeenshire IJB would take a number of months, the Integration Joint Board agreed:

(1)       to note that Amy Anderson would step down from the IJB and as Chair of IJB Audit Committee with effect from 30 November, 2023;

(2)       to note that a recruitment process would be commenced by NHS Grampian for the appointment of a non-executive Board Member, and once concluded they would appoint a replacement voting member to the Aberdeenshire IJB;

(3)       that once a replacement member for the IJB had been appointed by NHS Grampian the IJB would be in a position to make an appointment to the IJB Audit Committee; and

(4)       that current IJB Audit Committee member, Joyce Duncan, be appointed as Interim Chair of the IJB Audit Committee with effect from 1 December, 2023.

There had been circulated a report dated 20 September, 2023 by the Chief Finance and Business Officer, providing an update on the financial monitoring information for the 2023/24 financial year as at 31 August, 2023.

The Chief Finance and Business Officer provided an overview of the financial position as at the end of August 2023, the detailed position by service area, highlighted the areas which recorded the largest over budget positions and the largest underspends, and the budget virements proposed for approval, as contained in Appendix 3 of the report. He advised that in summary there was an over budget position of £7.831 million at the end of August 2023, equating to 4.8% of the IJB Budget; Health budgets at the end of August 2023 were over budget by £2.962 million, Social Care budgets were over budget by £4.125 million and Funds were over budget by £0.74 million. He advised that the forecast for the year, based on the August results, showed an overall budget of £11.9 million, with savings achieved and use of reserves of £3.050 million was forecast, equating to 2.9% of the IJB budget. He advised that these forecasts, in line with all other budget lines, would continue to be reviewed with partners, budget holders and finance colleagues to identify continuing trends and mitigations applied where applicable.

During discussion, Members commented on the following:

(a)       the need to ensure engagement and communication with staff side throughout the budgetary process;

(b)       further consideration to be given within budget lines as to controls and limitations, to assist in future plans;

(c)        to include within budgetary considerations adequate budget provision in areas with potential pressure points, such as locum provision;

(d)       note that confirmation of outstanding allocations from Scottish Government referred to in Section 9.1 of report would be clarified; and

(e)       to welcome a report on prescribing practice and strategy, to assist in budget setting.

 After further consideration, the Integration Joint Board agreed:

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

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

There had been circulated a report dated 27 September, 2023 by the Chair of the IJB Audit Committee providing an update on key issues in relation to Audit which had been progressed since the last meeting of the IJB. The report advised that since the last meeting, three reports had been presented to the Communities Committee as part of the Committee referral process in relation to the Aberdeenshire Alcohol and Drugs Partnership (ADP) Governance Arrangements; an Assurance Review of IJB Governance; and a report on IJB Transformational Projects.

The Chair of the IJB Audit Committee advised that although there had not been a formal meeting of the IJB Audit Committee since the last meeting of the IJB, work was continuing in a number of key areas, and a workshop session had been held on 22 September to consider a self-assessment exercise.

There was discussion of the different routes to be followed in relation to scrutiny processes and it was noted that the option existed, where considered necessary, for the IJB to apply additional scrutiny to certain areas. Ongoing work in relation to IJB governance was also nearing completion, which included examination of the scrutiny processes in place and would clarify the relationships of the various policy committees and the IJB and its committees.

Thereafter, the Integration Joint Board agreed to note the terms of the report and assurances in relation to audit matters.

There had been circulated a report dated 5 September, 2023 by the Chief Social Work Officer introducing the Chief Social Work Officer (CSWO) Annual Report for 2022/23. The report advised that (1) the CSWO report described those services which were performing well in most of the key areas upon which the report was focussed; (2) in those areas where improvement was required, timely and effective remedial measures had been put in place; (3) currently there were no specific areas that required additional scrutiny beyond that provided by existing processes.

The Chief Social Work Officer introduced the report and responded to questions raised by Members of the Integration Joint Board in relation to the impacts on unpaid carers and pockets of unmet need, particularly in rural areas, and the need to think creatively and ensure appropriate engagement; clarification was sought of the route for reporting information from Quarriers annual report; further information was requested on the percentage of care staff receiving the real living wage.

After further discussion, the Integration Joint Board agreed:

(1)           to note the Chief Social Work Officer Annual Report for the 2022/2023 financial year in relation to Children and Adult Social Work Services (Appendix 1);

(2)           to acknowledge the level of investment in Children and Adult Social Work Services for the residents of Aberdeenshire; and

(3)           to acknowledge the commitment of social work staff in the consistent delivery of high performing services.

There had been circulated a report dated 9 September, 2023 by the Chief Officer providing information on the progress of the NHS Grampian General Practice Vision Programme. The report explained that the role of the Programme Board is to oversee the progress of the programme, to ensure timely progress on actions including the development of a shared vision, and to ensure that the strategic direction of the programme remained on track. A series of facilitated workshop sessions had been organised to develop the vision and strategic objectives and a Service Level Agreement had been created to enable GP practices to ensure appropriate staff engagement in the project. A patient engagement plan had been developed to ensure a co-production approach and patients from across Grampian would be involved in the development of the vision and strategic objectives.

During discussion, Members commented on the need for the strategy and aims to be realistic, in order to ensure that it can be adequately funded and in addition that the plan should look ahead to the longer term to ensure that resources are deployed and staff are trained to deliver the multidisciplinary needs of the future. There was also discussion of the proposals for the creation of patient stakeholder groups, and the need to ensure that public communications were issued to ensure appropriate coverage.

Thereafter, the Integration Joint Board agreed to note the progress of the NHS Grampian General Practice Vision Programme.

There had been circulated a report dated 13 September, 2023 by the Chief Officer, providing an overview of the first Annual Vaccination and Immunisation Report for NHS Grampian. A copy of the report was provided as Appendix 1 to the report.

The Board heard from Dr Clare-Louise Walker and Jo Hall, Programme Manager, who provided an overview of the report, which set out to provide an annual monitoring report of vaccine preventable disease surveillance data, along with update data for each vaccine delivered within Grampian. Highlights indicated that there had been declines in childhood vaccination uptakes in both Grampian and Scotland, and Aberdeenshire continued to meet the WHO 95% update for all childhood routine schedules at 12 and 24 months, although at 5 years of age update was slightly below 95%. Uptake in teenage programmes had seen disruption during the Covid-19 pandemic and work was ongoing to ensure catch up, with Aberdeenshire continuing to exceed Grampian averages. Adult routine programmes were paused during the pandemic and were then transferred to health board/Health and Social Care Partnership delivery and Aberdeenshire had made good progress in ensuring all eligibly cohorts were offered relevant vaccines.

In relation to the priorities for improvement to ensure that vaccination rates were maintained and improved, the need to ensure a joint approach to messaging to the public was highlighted.  

After discussion, the Integration Joint Board agreed to acknowledge the findings of the NHS Grampian Vaccination and Immunisation Annual report 2023.

There had been circulated a report dated 15 September, 2023 by the Director of Environment and Infrastructure Services providing an update on the process which had been commenced to develop a Place Strategy for Aberdeenshire as a long-term approach to achieve positive change and improve outcomes across our communities.

The Board heard from the Head of Planning and Economy, who introduced the report and advised that a Place Strategy steering group had been created to oversee the development of the strategy and the group had been expanded to ensure third sector engagement, which included a wide range of services and partner organisations, including the Health and Social Care Partnership, NHS Grampian and blue light services. Public consultation exercises had been progressed and a draft strategy was being developed, which would be issued for consultation via Area and Policy Committees, as well as the IJB and Community Planning Partnership Board, before being reported to Aberdeenshire Council in January 2024.

During discussion, it was acknowledged that the IJB, from a health and social care partnership perspective, would be a key partner and would wish to participate in place based working and a place based strategy, and going forward would be one of the partners around the table and welcomed the benefits of working in a joined up approach. The need to ensure that the right services were provided in the right places, and that the work to enable that was aligned and all partners were working together to shape the location and distribution of future services.

After further discussion, the Integration Joint Board agreed:

(1)           to acknowledge the work undertaken in developing a Place Strategy for Aberdeenshire;

(2)           to note the next steps to develop the Strategy outlined in section 5.5 of the report;

(3)           to note that following further consultation, a Place Strategy would be reported to Aberdeenshire Council on 18January 2024 for approval; and

(4)           to acknowledge the HSCP’s participation in the developing Place Strategy work and to support the IJB in working towards alignment with the Place Strategy.

There had been circulated a report dated 13 September, 2023 by the Chief Officer which provided a summary of the main items of discussion at the most recent formal meeting of the Strategic Planning Group (SPG), including (1)  an update on current key areas of local and national policy developments, covering the UN Convention on the Rights of the Child; the NHS Grampian Director of Public Health Annual Report; and Improving Outcomes for Children and Young People – Aberdeenshire Children and Young People’s Services Plan 2023-26; (2) an update on the development of a digital strategy, which had been agreed as apriority workstream, advising that a full engagement process would be undertaken with links to wider partnership approaches; (3) an update on the work of the Social Care Sustainability Programme Board; and (4) an update of the Review of the Strategic Plan.

The Interim Transformation and Strategy and Transformation Manager introduced the report, provided further background, and responded to questions in relation to the oversight for timelines, deliveries and project management of the projects

After discussion, the Integration Joint Board agreed:

(1)           to acknowledge the report from the Strategic Planning Group (SPG) following its meeting on 24^th August 2023, including the project update on the Digital Strategy workstream; and

(2)           to endorse the outcomes of the SPG’s review of the Aberdeenshire Health and Social Care Partnership (HSCP) Strategic Plan as required by legislation to thereafter be published and used to shape and inform stakeholder engagement in development of the HSCP’s next Strategic Plan.

There had been circulated a report by the Vice-Chair of the Clinical and Adult Social Work Governance Committee, updating the Integration Joint Board on the key issues arising from the Committee meeting on 22 September 2023.

The Partnership Manager, North, introduced the report and provided an update on recent work undertaken by the Committee, which included consideration of a revised G-OPES assurance framework; a report from the Primary Care Oversight Group which highlighted the challenges being faced in being unable to deliver all the services tasked; a report from the Clinical and Professional Oversight Group for Care@Home which highlighted the challenges of recruiting carers and the steps being taken to address the issue; a report from the Collaborative Care Home Support Team addressing the deepening financial crisis impacting care homes in Aberdeenshire, as well as capacity issues in care home places; a report on the Risk Register, which was deferred to the next meeting; and a Whistleblowing Annual Report for 2022-23, which provided a summary of whistleblowing activity across health and social care partnership services.

After discussion, the Integration Joint Board agreed to note the key points and, in particular, the areas of concern from the Committee in relation to governance matters.

There had been circulated a report dated 9 September, 2023 by the Chief Officer which provided a high level overview of all the projects within the Health and Social Care Partnership’s Strategic Delivery Plan and outlining overall progress and enabling exception reporting of any key barriers or delays. The report also included a more detailed update on the progress against delivery of the Medication Assisted Treatment (MAT) Standards.

The Interim Strategy and Transformation Manager introduced the report and provided an overview of the work that was ongoing and highlighted relevant updates on the various workstreams.

After discussion, the Integration Joint Board agreed:

(1)           to note the high-level quarterly performance report on the HSCP Strategic Delivery Plan to end of August 2023, noting work ongoing regarding the prioritisation of workstreams;

(2)           to acknowledge the update on progress relating to the Analogue to Digital Project within the Strategic Delivery Plan;

(3)           to endorse the accompanying quarterly report on specific progress against the Medication Assisted Treatment (MAT) Standards Implementation; and

(4)           in line with agreed 6 monthly reporting schedule, to refer the report to the Communities Committee and Area Committees as part of the Performance Reporting Framework.

With reference to the minute of meeting of the Integration Joint Board of 7 December, 2022 (Item 7), there had been circulated a report dated 12 September, 2023 by the Partnership Manager, South providing an update on progress with the Deeside Strategic Needs Assessment Project. The Partnership Manager, South introduced the report and provided an update on work that had been ongoing, including staff and stakeholder engagement, community information sessions, a workshop to discuss recruitment and retention across health and social care services across Deeside and Upper Donside, and outlined work that was still ongoing in relation to the Strategic Needs Assessment.

After consideration, the Integration Joint Board agreed:

(1)           to acknowledge the Deeside Strategic Needs Assessment Project Progress Report (Appendix 1);

(2)           that the original reports and minutes on the Deeside Strategic Needs Assessment be re-circulated for Members’ information;

(3)           to delegate to the Chief Officer, in consultation with the Chair and Vice-Chair to consider the outcomes of the assessment and actions, and identify any gaps or learning and to report back to the IJB; and

(4)           that the item be added to the IJB action log.

There had been circulated a report dated 11 September, 2023 by the Chief Officer containing a draft response to the Health and Social Care Strategic Planning and Performance Reporting Statutory Guidance Consultation and seeking comments on the draft response. The Chief Officer introduced the report and outlined the consultation process that had been undertaken, and comments reviewed and collated in formulating the draft response.

During discussion, the need to clarify a number of points in the submission to provide a  more explicit response was discussed, and for an ‘on balance’ comment to be provided at item 10, taking account of the consultation comments received

After discussion, the Integration Joint Board agreed:

(1)           To note the draft response to the Health and Social Care Strategic Planning and Performance Reporting Statutory Guidance Consultation; and

(2)           To delegate to the Chief Officer to update and submit the consultation response in line with the comments made at the meeting.

There had been circulated a report by the Partnership Manager, North which provided information on the review and learning process of drug and alcohol related deaths and the actions already in place to prevent deaths in Aberdeenshire, seeking support for the progression of new notification processes for alcohol related deaths, and seeking approval and support for the promotion of wider distribution and availability of naloxone across Health and Social Care Partnership services.

The Criminal Justice and Substance Misuse Manager introduced the report and advised that in 2022 Aberdeenshire was the second lowest in Scotland in relation to drug related deaths and had the lowest rate of alcohol deaths per 100,000 of the population. However, 24 people lost their lives due to drug harm, and 35 due to alcohol harm. The report highlighted the main challenges around the established review process, which ensures that each notified death is discussed by a multi-disciplinary group to consider whole system learning through analysis of the circumstances and events leading up to the death; and this learning contributes to informing service improvements. The learning outcomes and related actions are shared with all staff that form the multi-disciplinary team at the review and any other partners that may benefit from the learning.

During discussion, Members acknowledged the very complex and difficult nature of the issues involved and were assured that the approach being taken to learning and improvement was embedded in the whole process and being documented and reported back to the IJB and for future learning.

After discussion, the Integration Joint Board agreed:

(1)           To note the review and learning process of drug and alcohol deaths and the actions already in place to prevent deaths in Aberdeenshire;

(2)           To approve and support the progression of new notification processes for alcohol related deaths;

(3)           To approve and support the promotion of wider distribution and availability of naloxone across Health and Social Care Partnership services; and

(4)           To acknowledge the support and work of the teams and to request an annual update.

There had been circulated a report dated 13 September, 2023 by the Chief Officer providing an update on the preparations being undertaken by the Aberdeenshire Health and Social Care Partnership with respect to winter planning for 2023-24, and on work underway to support a reduction in Delayed Discharges to enable maximisation of capacity through the winter period.

The Chief Officer introduced the report and referred to some key learning points around last year’s winter plan, and an engagement exercise across the Health and Social Care Partnership to gather views on the learning from last year’s winter plan, and areas for prioritisation. Learning had been taken from the use of the G-OPES escalation system and the role of the Health and Social Care Partnership as a Category One Responder. Work was ongoing for the forthcoming winter arrangements, as well as how they fit into the wider Grampian picture. Feedback had also been provided for a response to the Scottish Government’s  ‘state of readiness’ checklist for winter 2023/24, which requires local health and care systems to assess their preparedness in four key areas, and an extract of data had been provided within Appendix 1 to the report. In respect of delayed discharges, it was noted that a number of measures were used to monitor and manage delayed discharges, that performance had fluctuated over the last 18 month period, but had seen a sustained higher position since winter 2022/23.

After consideration, the Integration Joint Board agreed:

(1)           To note the preparations being undertaken by the Aberdeenshire Health and Social Care Partnership (AHSCP) with respect to winter planning for 2023-24; and

(2)           To acknowledge the current position and work underway by the AHSCP to support a reduction in Delayed Discharges and enable maximisation of capacity through winter. 

There had been circulated a report dated 5 September, 2023 by the Chief Officer requesting consideration of a Supplementary Procurement Work Plan and one Procurement Approval Form (PAF), and that the IJB directs Aberdeenshire Council to procure, via a tender opportunity, the services detailed in 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, which related to care and support services.

After consideration, the Integration Joint Board agreed:

(1)           to note the Supplementary Procurement Work Plan detailed in Appendix 1, and the Procurement Approval Form (PAF) at Appendix 2;

(2)           to approve the PAF 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; and

(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.