Agenda and minutes

The Chair asked for Declarations of Interest.

Angie Mutch advised that she had a connection to item 8, by virtue of having been appointed to a Scottish Government group working on a Suicide Prevention Plan for the next two years. She confirmed that having applied the objective test she had concluded that she had no interest to declare.

Councillor Keating advised that he had a connection to item 8, by virtue of having been a volunteer for Samaritans for the last 25 years. He confirmed that having applied the objective test he had concluded that he 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, 7 and 8 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 11 and 12 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, 7 and 8 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 11 and 12 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 the Integration Joint Board of 6 December 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 Aberdeenshire Health and Social Care Partnership’s Workforce Input to NHS Grampian’s Delivery Plan for 2024/25; (2) the General Practice Vision Programme; (3) Health Visiting and Family Nurse Services – UNICEF Baby Friendly Health Visiting Standards; (4) Dalvenie Gardens Very Sheltered Housing; (5) a Joint Inspection of Adult Support and Protection in the Aberdeenshire Partnership Area; and (6) a Scottish Government Consultation on The Learning Disabilities, Autism and Neurodivergence Bill consultation.

By way of update, the Chief Officer advised of a range of updates on the Workplace Plan which had to be submitted to NHS Grampian to feed into the NHS Grampian Delivery Plan for 2024/25, and an update on the Workplace Plan would to be reported to the next meeting of the IJB;  provided an update on the General Practice Vision Programme which had considered how to make general practice across Aberdeenshire sustainable going forward and looking at progress made at implementing the Primary Care Improvement Plan; that following a visit from the UNICEF baby-friendly initiative NHS Grampian Health Visiting and Family Nurse Services had fulfilled the requirements and achieved a GOLD award; an inspection of Dalvenie Gardens Very Sheltered Housing as part of a pilot inspection from the Care Inspectorate for low-risk services had retained a grade of 5 (very good) standard, with a number of areas of work being commended; an ongoing update of the activity to date on the Joint Inspection of Adult Support and Protection in the Aberdeenshire Partnership Area, with Senior Leaders having attended a Professional Discussion Meeting and a staff survey was ongoing; noted that work was ongoing to minimise delayed discharges during winter and managing winter pressures had continued to incorporate close oversight and scrutiny of delayed discharges as a key performance metric and senior managers were meeting weekly to provide oversight and scrutiny of delayed discharges, supported by Location and Service Managers in each area; and initiatives to support staff health and wellbeing with access to resources being promoted to employees to ensure that wellbeing was an integral part to staff communications and programmes; and finally she highlighted a consultation on the Learning Disabilities, Autism and Neurodivergence Bill which aimed to bring a focus to help Scotland move towards a society where neurotypical and neurodivergent people, and people with learning disabilities having their needs met and their choices respected. She advised that members would be invited to share their views and a response on behalf of the Health and Social Care Partnership would be collated and shared with the Chair and Vice Chair for agreement prior to submission.

During discussion, Members commented on the issue of delayed discharge relating to waiting times for medications from the hospital pharmacy. It was noted that that timely access to medications to support hospital discharge is monitored also that the mechanisms for inpatient and primary /  ...  view the full minutes text for item 5.

There had been circulated a report dated 16 January 2024 by the Chief Officer, providing an update on the financial monitoring information for the 2023/24 financial year, which covered the period up to the end of November 2023.

The Chief Finance and Business Officer provided an overview of the financial position as at the end of November 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 November 2023 and the budget adjustments proposed for approval, as contained in Appendix 3 to the report. He outlined the forecast position for 2023/24, based on the November results, which showed a forecast overspend of £16.997 million, equating to 6.0% of the IJB budget. He highlighted that Health budgets at the end of November 2023 were over budget by £4.4 million, Social care budgets were over budget by £12.2 million and Funds at the end of November 2023 were over budget by £0.453 million. The areas which recorded the largest over budget positions were GP prescribing, Other Direct Patient Care, Adult Services Community and Residential Care and Older People Care Management and Residential Care. He advised that the information provided assumed the achievement of £4.7 million of efficiency savings in 2023/24 and the recovery plan communication to budget holders from the Chief Officer emphasised the requirement to ensure achievement of agreed savings which would continue to be monitored and reported to the IJB.

In terms of next steps, he confirmed that meetings were continuing to be held to review the current financial position and the impact on 2024/25 and beyond and budget development sessions would continue with the IJB, with work ongoing to identify areas of potential mitigation. In addition, work was ongoing within the budget setting process for 2024/25 with the budget due to be presented to the IJB for approval on 20 March 2024.

The Chief Officer highlighted the pressures that were driving the budget overspend and the work that was ongoing to put a focus on those pressure areas to identify if they could be mitigated. The two main pressures were prescribing and adult social care, and those were both indicators of the complexity of need, the demographics and on an escalating line of pressure and were driving part of the main challenges in terms of budget pressures. She advised of ongoing work to focus on pressure areas and to seek measures to mitigate these areas and there would be a continued focus of scrutiny through future reporting.

During discussion, Members commented on (a) the use of earmarked reserves and timeline for confirmation of their use; (b) noted ongoing discussions with Finance teams within the partner organisations on potential requirement for funding to address an over budget position of the IJB budget at year end; (c) the need for reinforcement of the need to achieve a balanced budget by financial year end; (d) the very serious pressure of the spend on the Prescribing budgets  ...  view the full minutes text for item 6.

There had been circulated a report dated 16 January 2024 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 of the IJB, the Audit Committee had approved for sign off the audited accounts on 29 November 2023 and officers had agreed to the recommendations set out in the detailed Action Plan and would report back to the next meeting of the IJB Audit Committee in February 2024. An update was also provided on a recent meeting of the Risk Assurance Group and updates to the Risk Register and a review of the Risk Register and the Strategic Development Plan reporting structure.

The Joint Board heard from Mrs Duncan, Chair of the IJB Audit Committee, who confirmed that the Committee had been assured by the External Audit report and the Action Plan coming from that and the progress with the recommendations; the Committee was well assured on the ongoing work on Risk matters and progress being made; that action plans for the two audits still in process were being progressed and two new audit processed had commenced. Some concerns had been expressed around some areas where the IJB do not have full control of issues, such as workforce issues, the new Health and Care Workforce Act, but there were no issues which required escalation at the present time.

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

There had been circulated a report dated 5 January 2024 by the Partnership Manager, North which asked the IJB to consider, comment on and approve the Aberdeenshire Suicide Prevention Action Plan 2023-24.

The Mental Health and Learning Disabilities Service Manager, Central introduced the report and advised that the Aberdeenshire Suicide Prevention Action Plan had come about from the new national strategy for Suicide Prevention, known as ‘Creating Hope Together’, published in September 2022, covering the period 2022-2025. A Suicide Prevention Delivery Group had been established, with a wide stakeholder participation, and had prioritised a range of tasks for 2023-24 within an Action Plan. Work was also being undertaken on a wider Grampian basis, along with Moray and Aberdeen City and other stakeholders, working on the four outcomes within the Strategy. Work was ongoing to advertise and encourage the use of an Aberdeenshire Suicide Prevention app and an increase in usage was seen across the festive period. Two Community Engagement Officers were now in post, employed through SAMH to provide local support across Aberdeenshire and to implement the Action Plan.

There was discussion of information sharing from a Scottish Government evaluation of the first year of the Delivery Plan of the ‘Creating Hope Together’ Strategy; proposed training for carers and professionals, which would be targeted at different levels, depending on need; the need to ensure support for young people who may be in alternative education and not in the school system; work ongoing at a national level to develop an online programme for suicide prevention which talks to young people; the importance of the voice of lived experience to support this work going forward; the need to ensure that as part of the workforce and health and wellbeing work needs to be embedded in order to support staff.

There were some concerns expressed around the need to ensure that the work in relation to the Suicide Prevention Plan was not replicating or repeating work already done and was focussed on aspects that would give added value to an issue. Any action plan should seek to address gaps that may need to be filled and work should build upon existing work at a local, national and international level to avoid duplication.

After discussion, the Integration Joint Board agreed:

(1)           to note the Aberdeenshire Suicide Prevention Action Plan 2023-2024;

(2)           that officers should take cognisance of the comments raised within the meeting and ensure that future provision was tailored to meet the needs and avoid duplication of work;

(3)           that Year 2 of the Plan should take account of the discussion of the IJB and should address the concerns raised and ensure a link across the community planning agenda, and all relevant services and stakeholders and should be reported to the first meeting of the IJB after the summer recess (21 August 2024).

There had been circulated a report dated 28 December 2023 by the Chief Officer which provided a summary of the main items of discussion at the most recent meeting of the Strategic Planning Group (SPG). The report advised that a range of reports had been considered at the last meeting and included a Programme Board Update Report on the Social Care Sustainability Programme. The report noted the continued progress being made across the Social Care Sustainability Programme, whilst recognising the impact of operational demands.

The Interim Strategy and Transformation Manager introduced the report, highlighted a range of work being undertaken by the SPG and highlighted the joint strategic needs assessment which followed with the agreement of the SPG to commence work in preparation for the development of the Partnership’s next Strategic Plan, and noted that the timeline for this was currently under development.

During discussion clarification was sought on proposed funding for project officer costs in relation to current budgetary pressures, and the potential impacts in terms of adjustment of milestones, timelines and objectives in terms of what can be delivered within available resources was acknowledged. However, the need to ensure that projects were progresses was highlighted in order to ensure the necessary transformational change was progressed. For future reports, further information on outcomes was requested, to highlight the impacts of the projects on the outcomes.

Thereafter, the Integration Joint Board agreed to acknowledge the report from the Strategic Planning Group (SPG) following its meeting on 12 December 2023.

There had been circulated a report dated 19 December 2023 by the Chief Officer, which provided the quarterly performance report on the H&SCP Strategic Delivery Plan to the end of November 2023, and outlining work ongoing regarding the prioritisation of workstreams. The aim of the report was to provide a high level overview of all projects, outlining overall progress and enabling exception reporting of any key barriers or delays. As agreed by the IJB the report also included a more detailed update on the H&SCP’s progress against delivery of the Medication Assisted Treatment (MAT) Standards.

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

The Integration Joint Board agreed:

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

(2)           to note the monitoring and reporting of activity linked to vaccinations will now be reported under the Primary Care Improvement Programme Board therefore this has been removed from the Strategic Delivery Plan as an individual project;

(3)           to note the development and reporting of activity linked to the Primary Care Mental Health Hub will be considered as part of the new Aberdeenshire Mental Health Strategy therefore this will be removed from the Strategic Delivery Plan as an individual project; and

(4)           to endorse the accompanying quarterly report on specific progress against the Medication Assisted Treatment (MAT) Standards Implementation.

There had been circulated a report dated 20 December, 2023, by the Chief Officer which explained that the Annual Work Plan for procurement to be undertaken during 2024/2025 was outlined and required a Direction to be given to Aberdeenshire Council.

It was emphasised that there may be unexpected procurements or emergency situations that arise in the financial year, and in this situation, officers would submit a Supplementary Work Plan requiring the approval of the Integration Joint Board.

The Strategic Procurement provided further information, in particular highlighting that there were three items on the Annual Procurement Work Plan. These were: Support at home services for adults with Complex Needs and Learning Disabilities; Residential Services for Adults with Learning Disabilities and Mental Health Issues; and National Care Home Contracts for residential services for older people.

The Integration Joint Board agreed to:

(1)      approve the Annual Procurement Work Plan, detailed in Appendix 1, and the one Procurement Approval Form (PAF) and two Award Reports, detailed in

           Appendix 2 (A-C);

(2)           review the Procurement Approval Form and Award Reports for items on the Work Plan which were within the Joint Board’s remit and the value of the matter was over £1,000,000 and to note that the Procurement Approval Forms for items 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 was implemented;

(3)           direct Aberdeenshire Council to direct award and extend the services detailed in the Annual Procurement Work Plan on behalf of the Joint Board;

(4)           note the updates on Out of Area Individual Placements; and

(5)      note that the contract requirements relating to care and support services aligned with the Joint Board’s Strategic Plan in relation to “Outcome 2: People, including those with disabilities or long-term conditions or were frail, were able to live independently at home or in a homely setting in their community”; and additionally, an update on the outcomes from the approved procurements in the report would be included in the Commercial and Procurement Shared Service’s Annual Report.

There had been circulated a report dated 9 January, 2024, by the Chief Officer which explained that one direction required to be issued to Aberdeenshire Council. The detail of the specific direction was outlined in Appendix 3.

As background, the report reminded the Joint Board that the Communities Committee of Aberdeenshire Council act under Direction from the Integration Joint Board. Where the Contract Value for new contracts was over £1,000,000 approval of the Business Case must be given by the Communities Committee in accordance with the Financial Regulations and where the Contract Value for new contracts was between £50,000 and £1,000,000, the Business Case may be approved by the relevant Chief Officer and notified to the Head of Commercial and Procurement Services. However, the Communities Committee may choose to reserve any item on the Work Plan which was within its remit and such item would then require its Business Case to be reported to the Communities Committee prior to the Service being authorised to undertake the procurement and/or issue the appropriate contracts. This ensured that there was appropriate scrutiny over the procurement process and provided assurance to the Integration Joint Board that robust governance controls the spend of the budget under Direction. 

The Integration Joint Board agreed to:

(1)      approve the Supplementary Procurement Work Plan detailed in Appendix 1 and the Procurement Approval Form in Appendix 2;

(2)           review the Procurement Approval Form for items on the Procurement Plan which were within the Integration Joint Board’s remit and the value of the matter was over £1,000,000 and to note that the Procurement Approval Forms for items 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 was implemented;

(3)           direct Aberdeenshire Council to procure the works detailed in the Supplementary Work Plan on behalf of the Integration Joint Board; and

(4)           note that the works aligned with the Aberdeenshire Health and Social Care Partnership Property Asset Strategy.