Agenda and minutes

The Chair asked for Declarations of Interest. There were no interests 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 making decisions on the following 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)       where an equality impact assessment has been provided, to take its contents into consideration when reaching a decision.

Exempt Information

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

       “That under paragraphs 2 and 3 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 13 and 14 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 13 and 14 of the business below, on the grounds that it involves the likely disclosure of exempt information of the classes described in the relevant paragraphs.

(a)  MINUTE OF MEETING OF THE INTEGRATION JOINT BOARD OF 1 MARCH 2023

There had been circulated, and was approved as a correct record, the Minute of Meeting of 1 March, 2023.

(b)  MINUTE OF MEETING OF THE INTEGRATION JOINT BOARD OF 29 MARCH, 2023

There had been circulated, and was approved as a correct record, the Minute of Meeting of 29 March, 2023.

(c)  IJB AUDIT COMMITTEE APPROVED MINUTE OF 7 DECEMBER, 2022

There had been circulated, and was noted, the approved Minute of Meeting of the Audit Committee of 7 December, 2022.

The Chief Officer gave a presentation on the work of the North East Alliance, which is a collaboration across the public sector in the North East of Scotland. The Alliance brings together local government, the NHS, Police, Fire and Rescue and Integration Joint Boards to work with its citizens to improve their lives. She explained that the Alliance had been created with a view to creating a system of public health learning across and within the existing partnership arrangements and to reverse current trends. She outlined the key priorities of the Alliance and some of the priorities which featured under a number of key themes – to strengthen the building blocks for collaborative working; to grow the membership through a shared vision for population health; to deliver change and embed learning, and how this work was adding value to existing partnership work in Aberdeenshire.

During discussion, Members commented on the vision of the Alliance and the need to avoid any duplication with the work of other agencies and partners, such as the Community Planning Partnership; they hoped that the document would be shared widely; it was noted that a monitoring framework was in place to ensure that actions were progressed and that a combination of data on individual projects and workstreams would be used in the monitoring process. In terms of delivering improved population health, it was suggested that common learning and the use of best practice found in other areas should be welcomed.

After consideration, the Integration Joint Board agreed to welcome regular update reports on the work of the North East Alliance.

There had been circulated 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 Integration Joint Board.

In respect of item 2 on the action log, it was noted that a scrutiny workshop had been arranged for 14 June 2023. In other respects, the report was noted.

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 the National Care Service (NCS) Bill; an update on the current position in relation to the status of the Community Hospitals and Minor Injury Units in Aberdeenshire; an update advising that the Health and Social Care Partnership had recently taken over the operation of the Balhousie Huntly Care Home, following concerns raised by the Care Inspectorate and subsequent court action; and an update on the delivery of medical services at Fyvie/Oldmeldrum and Inverurie Medical Practices.

There was discussion around the effects of current bed limitations within some community hospitals and the implications for new directives on staffing levels in community hospitals, with work ongoing in this regard to consider the implications. It was noted that with regard to the Balhousie Huntly Care Home work was ongoing to ensure the continued operation and support of the home and to work was underway to seek a new operator for the home. Thanks were given to the leadership team and all the staff involved for their efforts and hard work for keeping the residents safe during this challenging period. The Chief Officer also advised Members of ongoing work to seek interest from other GP partnerships to take on the Inverurie Medical Practice contract and updated Members on the arrangements for the running of the Fyvie/Oldmeldrum Medical Practice.

After discussion, the Integration Joint Board agreed:

(1)       that the Chief Officer should provide a briefing note on the implications for new directives on staffing levels in community hospitals, addressing the issue of risks and proposed mitigations;

(2)       that the Chief Officer should report back on developments with the Inverurie and Meldrum/Fyvie Medical Practices;

(3)       that the Chief Officer should provide a briefing note on the forthcoming visit by Scottish Government officials to primary care settings in Aberdeenshire, including some practices where contracts have been handed back; and

(4)       in other respects to note the terms of the updates provided.

There had been circulated a report dated 28 April, 2023 by the Chief Finance and Business Officer providing an update on the financial monitoring information for the IJB Revenue Budget. It explained that work was ongoing to finalise the draft outturn and unaudited annual accounts for the financial year 2022/23, and these would be reported to the next meeting of the IJB and the unaudited accounts to the IJB Audit Committee in July 2023.

The Chief Finance and Business Officer provided an overview of the financial position and advised that monthly budget monitoring would be undertaken, with the forecast outturn position for the financial year 2023/24 updated with the focus on the high value/high risk budget lines, based on recurring pressures identified from previous financial years. He advised that work on the 2024/25 budget had already commenced, and a revised Medium Term Financial Strategy would be presented to the IJB in July and it was highly likely that additional savings and efficiencies would require to be identified to achieve a balanced position through the budget setting process for 2024/25. He highlighted that the Medium Term Financial Strategy and the Reserves Strategy would be key tools in ensuring that a balanced budget could be achieved, and the use of ‘scenario planning’ to identify areas where mitigations would need to be put in place, along with continued monitoring, was proposed.

Thereafter, the Integration Joint Board, having considered the financial position as detailed in the report and appendices, agreed:

(1)       to note the  IJB Revenue Budget update; and

that the Chief Finance and Business Officer should report to the next meeting on the identification of owners and actions in relation to ongoing work on efficiencies and a timeframe with key milestones for the rest of the year.

There had been circulated a report by the Chair of the Clinical and Adult Social Work Governance Committee, updating the Joint Board on the key issues arising from the Committee meeting on 17 March, 2023.

The Joint Board heard from Mr Lindsay, Chair of the Committee, on the recent work undertaken by the Committee, which included consideration of the sustained pressure within the Partnership and its services which had been at G-OPES Level 4 for an unprecedented length of time. He reported that the G-OPES level had since moved to 3, and the Chief Officer outlined the steps being taken to mitigate the underlying issues causing the sustained pressure on the system.

After discussion, the Integration Joint Board agreed to note the key points and assurances highlighted in the report by the Committee in relation to governance matters.

There had been circulated a report dated 1 May, 2023 by the Chair of the IJB Audit Committee, providing an update on business considered by the Committee at its meeting on1 March, 2023, including clarification in terms of Internal Audit Reports that fall to be considered by both the Council’s Audit Committee and the IJB Audit Committee; an update on the National Care Service and the timeline for its progress; an update on progress of the Internal Audit Plan and progress of the 2022-23 audits, highlighting that the IJB Governance Arrangements report had been issued, and three other reports relating to Adults with incapacity, Criminal Justice and Day Care Establishments were currently under review. The report also provided an update on the latest position of a number of Audit recommendations which were in process.

The Chief Officer provided an overview of the work that was underway and acknowledged the importance of the role of the IJB in seeking assurances around the various recommendations arising from the audits and the issues that had been raised. She advised that a number of systems and processes were being reviewed and officers were working intensely and with the support of officers from the Internal Audit service. Ms Lauren Cowie, Principal Solicitor had been seconded to work with the Health and Social Care Partnership to provide expert advice and support and to strengthen the governance processes which were in place and officers were working closely with other Council colleagues to look at areas of good practice and learning to assist in this work.

Thereafter, the Integration Joint Board agreed:

(1)       to note the key points and assurances from the Committee in relation to audit matters;

(2)       that the action plans for each of the audits should be circulated to IJB Members, to include timelines for completion;

(3)       to note that the Communities Committee were meeting on 10 May to consider a Level 2 Scrutiny Process in relation to the ADP Audit and a further update would be provided thereafter;

(4)       that the IJB Audit Committee should ensure they take forward consideration of the audits timeously and make any escalations to the IJB as necessary; and

(5)       to receive a further report on progress being made on the recommendations of the audits to the IJB meeting on 5 July and the report should include consideration of ‘risk’.

There had been circulated a report dated 25 April, 2023 by the Chief Officer providing an update on a range of specialist services operating under ‘Hosted Mental Health and Learning Disability Services’.

The Lead Officer for Hosted MHLDS, Inpatients, Specialist Services and CAMHS introduced the report and provided some further context to the high level summaries included in the report. She highlighted that all Mental Health and Learning Disability Services were delegated with no services now being managed under NHS Grampian. Currently the budgets for the ‘hosted’ services sat with NHS Grampian and a proposal to transfer the budgets to IJBs was under consideration.

There was discussion of the waiting times for psychological therapies within NHS Grampian which had resulted in the Board receiving tailored support from the Scottish Government to create an improvement and development plan to understand and address the issues; the learning put in place in relation to complaints to ensure that the issues arising were not repeated; and the implications of a significant forecast overspend on the service. In addition, there were concerns expressed regarding the potential for a service currently incurring an overspend to be transferred to IJBs, and Members considered that this matter should be referred to the Clinical and Adult Social Work Governance Committee for further detailed consideration.

After consideration, the Integration Joint Board agreed:

(1)       to note the risks and the progress made with regard to the risks identified;

(2)       to note the update report and the information within the report;

(3)       to remit consideration of the report to the Clinical and Adult Social Work Governance Committee; and

(4)       that the IJB would not accept delegation of this budget with its existing overspend and that the Chief Officer should monitor and provide a briefing note on the implications of delegating this budget and the existing overspend referred to in paragraph 4.17 of the report when a proposal comes forward from NHS Grampian.

There had been circulated a report dated 17 April, 2023 by the Interim Partnership Manager, Central which provided an update on scoping work undertaken on the transition of young people from Children to Adult Social Work Services, to ensure an effective collaboration and joint working across all services to provide support to young people when transitioning to adult services.

The report advised of scoping work being undertaken to ensure that young people and their families across Aberdeenshire were provided with the right support, at the right time, by the right people, through the GIRFEC (Getting it Right for Every Child) Thematic Group, which aimed to ensure more effective collaboration and joint working across all services that would provide support to young people when transitioning to adult services.

After discussion, the Integration Joint Board agreed:

(1)       to note the scoping work on transitions from Children’s to Adult Services undertaken by Aberdeenshire’s GIRFEC Children with Disabilities Thematic Group;

(2)       to receive a further report as work on the Transitions Charter, Pathway and Guidance progresses; and

(3)       that Officers should include examples of case studies or lived experience in future reports, as well as budgetary resource implications.

There had been circulated a report dated 26 April, 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 an update on progress with the NHS Grampian Plan for the Future, which was a 3 year delivery plan to 2026 in response to Scottish Government guidance; an update on the National Care Service advising that Scottish Ministers have requested a further extension to the Scottish Parliament’s consideration of the National Care Service Bill; progress with the Review of the IJB Strategic Plan, as required under the Public Bodies (Joint Working)(Scotland) Act 2014; work by officers to review work under the new Strategic Delivery Plan to 2025; and work underway in response to a recent Internal Audit to review arrangements for ensuring clear reporting, approval and documentation of project changes and controls.

After discussion, the Integration Joint Board agreed:

(1)       to acknowledge the report from the Strategic Planning Group (SPG) following its meeting on 20^th April 2023;

(2)       to receive a report in October on the outcomes of the SPG’s review of the HSCP’s Strategic Plan as required by legislation;

(3)       to acknowledge the ongoing work to review and strengthen the HSCP’s approach to implementation of its Strategic Delivery Plan 2022-2025.

There had been circulated a report dated 12 April, 2023 by the Chief Officer which provided an overview of the directions which had been issued by the Aberdeenshire IJB during the period 1 April 2022 to 31 March 2023. The report explained that under the Public Bodies (Joint Working)(Scotland) Act 2014, integration authorities were provided with the mechanism to issue binding directions to the Health Board and/or Local Authority, to enable the IJB to action its strategic commissioning plan for how it would plan and deliver services using integrated budgets under its control, providing the legal basis on which the Health Board and Local Authority deliver services under the control of the IJB. The report provided a list of the directions which had been issued between 1 April 2022 and 31 March 2023.

After consideration, the Integration Joint Board agreed:

(1)       to acknowledge the use of directions as provided in the annual report in Appendix one; and

(2)        that the report be shared by the Chief Officer with the Chief Executives of both Aberdeenshire Council and NHS Grampian respectively to provide an overview of the directions which have been issued between April 2022 – March 2023.

There had been circulated a report dated 27 April, 2023 by the Chief Officer which requested that the Integration Joint Board note the use of special urgency powers by the Chief Officer in connection with the provision of a residential care home service for older people and to ensure that the service continued until a new provider was identified and registered appropriately to provide the service.

Having heard from the Chief Officer as to the background to the report, the Integration Joint Board agreed to note the use of special urgency powers by the Chief Officer, as the process agreed by the IJB in 1.9 and 1.10 of the IJB Governance Handbook to approve the recommendations in Appendix 1.

Paragraph 2 - Information relating to any particular occupier or former occupier of, or applicant for, accommodation provided by or at the expense of the IJB, council or the health board.

Paragraph 3 - Information relating to any particular applicant for, or recipient or former recipient of, any service or financial assistance provided by the IJB, the council or the health board.

Paragraph 6 - The amount of any expenditure proposed to be incurred by the IJB, the council or the health board under any particular contract for the acquisition of property or the supply of goods or services, provided that disclosure to the public of the amount there referred to would be likely to give an advantage to a person entering into, or seeking to enter into, a contract with the authority in respect of the property, goods or services.

Paragraph 7 - Any terms proposed or to be proposed by or to the IJB, the council or the health board in the course of negotiations for a contract for the acquisition or disposal of property or the supply of goods or services, provided that disclosure to the public of the terms would prejudice the authority in those for any other negotiations concerning the property or goods or services.