Publication

At a MEETING of the DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held at Dundee on 27th June, 2017.

Present:-

Members	Role
Ken LYNN (Chairperson)	Nominated by Dundee City Council (Elected Member)
Roisin SMITH	Nominated by Dundee City Council (Elected Member)
Helen WRIGHT	Nominated by Dundee City Council (Elected Member)
Judith GOLDEN	Nominated by Health Board (Non Executive Member)
Munwar HUSSAIN	Nominated by Health Board (Non Executve Member)
David W LYNCH	Chief Officer
Dave BERRY	Chief Finance Officer
Sarah DICKIE	Registered Nurse
Drew WALKER	Director of Public Health
Raymond MARSHALL	Staff Partnership Representative
Jim MCFARLANE	Trade Union Representative
Christine LOWDEN	Third Sector Representative

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

Roger MENNIE	Clerk and Standars Officer
David SHAW	Dundee Health & Social Care Partnership
Jackie STEWART Jimmy BLACK Val JOHNSTONE Neil PRENTICE Keith RUSSELL Lynne HAMILTON Bill NICOLL	Dundee Health & Social Care Partnership Dundee Voluntary Action (Communications Officer) NHS Tayside, (Head of Adult Mental Health and Learning Disabilities Inpatients) NHS Tayside (Medical Director) NHS Tayside (Associate Nurse Director Mental Health) NHS Tayside (Mental Health Programme Director and Finance Manager NHS Tayside (Director of Strategic Change)
Diane MCCULLOCH	Dundee Health and Social Care Partnership (Head of Community Health and Care Services)

Ken LYNN, Chairperson, in the Chair (from Article III of this minute onwards).

I INTERIM CHAIR

Roger Mennie, Clerk and Standards Officer of the Dundee City Health and Social Care Integration Joint Board chaired the meeting in the interim prior to the appointment of the Chairperson.

II MEMBERSHIP DUNDEE CITY COUNCIL

It was reported that Dundee City Council had nominated the following members to serve as members of the Integration Joint Board:-

Councillor Ken Lynn

Councillor Roisin Smith

Baillie Helen Wright

The Integration Joint Board agreed to note the position and that their terms of appointment would be until May 2020.

III POSITION OF CHAIRPERSON DUNDEE CITY COUNCIL

It was reported that Dundee City Council currently held the position of Office as Chairperson of the Integration Joint Board.

The Integration Joint Board unanimously agreed that Councillor Ken Lynn be appointed as Chairperson of the Integration Joint Board as proposed and seconded by Councillor Roisin Smith and Bailie Helen Wright.

IV APOLOGIES FOR ABSENCE

Apologies for absence were submitted on behalf of; Doug Cross (Vice Chairperson), nominated by Health Board (Non Executive Member); Jane Martin, Chief Social Work Officer; Frank Weber, Registered Medical Practitioner (whose name was included in the list of primary medical performers); Cesar Rodriguez, Registered Medical Practitioner (not providing primary medical services); Andrew Jack, Service User Representative and Martyn Sloan, Carer Representative.

V DECLARATIONS OF INTEREST

No declarations of interest were made.

VI MEMBERSHIP SERVICE USER AND CARER REPRESENTATIVE

Reference was made to the minute of meeting of this Integration Joint Board held on 4th May, 2016 wherein the undernoted people were appointed as non-voting members on the Integration Joint Board.

Non Voting Member

Role

Andrew Jack

Service User Representative (service users residing in the area of the

local authority)

Martyn Sloan

Carers Representative (person providing unpaid care in the area of the

local authority)

It was reported that both Andrew Jack and Martyn Sloan had indicated that they would be willing to continue their membership of the Integration Joint Board in the capacity of these positions pending a review of support arrangements.

The Integration Joint Board agreed to their continued membership as reported.

VII MEMBERSHIP PERFORMANCE AND AUDIT COMMITTEE

It was reported that the membership of the Performance and Audit Committee comprised two voting members from Dundee City Council on the basis that they did not hold the positions of Chairperson or Vice Chairperson of the Integration Joint Board.

The Integration Joint Board agreed to note the position and that the remaining two voting members from Dundee City Council not holding the positions of Chairperson or Vice Chairperson of the Integration Joint Board would become members of the Performance and Audit Committee and that as such Bailie Helen Wright and Councillor Roisin Smith were appointed accordingly.

VIII STANDING ORDERS

The Standing Orders for the Integration Joint Board were submitted.

The Integration Joint Board agreed:-

(i) to adopt these as the Standing Orders for the Integration Joint Board; and

(ii) to note that the Clerk and Standards Officer was reviewing the Standing Orders and that an amended version would be brought forward in due course.

IX MINUTE OF PREVIOUS MEETING

The minute of the previous meeting of the Integration Joint Board held on 25th April, 2017 was submitted and approved.

X TECHNOLOGY ENABLED CARE

There was submitted Report No DIJB19-2017 by the Chief Officer providing an overview and progress with implementing Technology Enabled Care in Dundee.

Jimmy Black, Communications Officer, Dundee Voluntary Action gave a presentation in supplement to the report.

The Integration Joint Board agreed:-

(i) to note the content of the presentation by Jimmy Black;

(ii) to note progress in implementing Technology Enabled Care in Dundee; and

(iii) to note next steps in relation to Technology Enabled Care outlined in paragraph 5.2.5 of the report.

XI MENTAL HEALTH SERVICE REDESIGN TRANSFORMATION PROGRAMME OPTION REVIEW AND CONSULTATION PLAN REPORTS

There was submitted Report No DIJB4-2017 by the Mental Health Programme Director & Finance Manager, NHS Tayside presenting the preferred option from the review of Mental Health and Learning Disability Services undertaken by the Mental Health Service Redesign Transformation Programme and the proposed consultation plan. It was reported that the report would be presented to NHS Tayside Board and Angus and Dundee Integration Joint Boards to note and comment before seeking approval from the Perth and Kinross Integration Joint Board to progress to a period of formal consultation from 3rd July, 2017 to 3rd October, 2017.

Lynne Hamilton, Val Johnston, Neil Prentice and Keith Russell of NHS Tayside gave a presentation in supplement to the report.

The Integration Joint Board agreed:-

(i) to note the content of the presentation;

(ii) to note the details of the Option Review Board at section 4.5 of the report;

(iii) to note the process followed in undertaking the review and the level of engagement involved in the preparation and consideration of options for future General Adult Psychiatry and Learning Disability services;

(iv) to note the methodology used to identify the preferred option and justification for its choice over other options considered;

(v) to note the content of the consultation plan a copy of which was attached to the report as Appendix A; and

(vi) to note the requirement to proceed to a three month period of formal consultation in line with Scottish Government guidance on major service change.

XII NHS TAYSIDE (5 YEAR) STRATEGIC PLAN AND (1 YEAR) OPERATIONAL PLAN/DRAFT LOCAL DELIVERY PLAN (LDP)

There was submitted Report No DIJB20-2017 by the Director of Strategic Change, NHS Tayside informing the Integration Joint Board of the Strategic and Operational Plans of NHS Tayside and the implications for Dundee Health and Social Care Partnership.

The Integration Joint Board agreed to acknowledge the NHS Tayside Plans for their interest and their impact on strategic, operational and financial planning decisions for the Partnership.

XIII REMODELLING CARE FOR OLDER PEOPLE

There was submitted Report No DIJB21-2017 by the Chief Officer outlining the future provision of care to meet needs of older people which supported care in their own home or a homelike setting.

The Integration Joint Board agreed:-

(i) to note the contents of the report;

(ii) to note and approve the future direction of delivery of health and care for older people; and

(iii) to instruct the Chief Officer to conduct a full business case options appraisal in partnership with practitioners to determine the most effective and efficient mix of service models which would meet the care needs of older people within Dundee and to present this to the meeting of the Integration Joint Board to be held on 31st October, 2017 for approval.

XIV CRAIGIE HOUSE REPLACEMENT UPDATE REPORT

There was submitted Report No DIJB22-2017 by the Chief Officer advising members that following Report No DIJB42-2016, Future of Residential Care for Older People, provision had been made in the Dundee City Council Capital Plan for the re-provisioning of Craigie House and to seek approval for a report to be submitted to Dundee City Council Policy and Resources Committee to seek permission to progress this work.

The Integration Joint Board agreed:-

(i) to note the contents of the report; and

(ii) to recommend to Dundee City Council that a proposal be made to its Policy and Resources Committee to progress the investment in a new build care home as part of the Integration Joint Boards accommodation based care strategy.

XV HOSTED SERVICE ARRANGEMENTS

There was submitted Report No DIJB27-2017 by the Chief Finance Officer providing Dundee Integration Joint Board with an overview of the financial performance of Hosted Services across Tayside for 2016/17 and setting out the recovery plans being developed by Angus and Perth & Kinross Integration Joint Boards for those services facing significant financial pressures.

The Integration Joint Board agreed:-

(i) to note the financial performance of hosted services for 2016/27 and developing recovery plans for 2017/18 and beyond as noted in Appendix 1 of the report; and

(ii) to instruct the Chief Finance Officer to embed comprehensive financial monitoring information for services hosted by Angus and Perth & Kinross Integration Joint Boards and the implications for Dundee within the regular financial monitoring reports provided to Dundee Integration Joint Board.

XVI CLINICAL, CARE AND PROFESSIONAL GOVERNANCE INTERIM REPORT

There was submitted Report No DIJB24-2017 by the Head of Service, Health and Community Care & Clinical Director providing update information of clinical care and professional governance work currently underway across the Partnership.

The Integration Joint Board agreed:-

(i) to note the work undertaken to date across the Dundee Health and Social Care partnership and planned future work to improve the governance arrangements;

(ii) to note the extracted content of the first annual Dundee Health and Social Care Partnership Clinical Governance and Risk Management Report as detailed in sections 4.2 and 4.3 of the report; and

(iii) to note the information arising from the first service reports.

XVII DISCHARGE MANAGEMENT PERFORMANCE QUARTERLY UPDATE

Reference was made to Articles XIV and XV of the minute of meeting of this Integration Joint Board held on 30th August, 2016 wherein the Health and Social Care Integration Joint Board Discharge Management Improvement Plan, the Discharge Management Performance report and the Discharge Management Plan Update Report were approved.

There was submitted Report No DIJB23-2017 by the Chief Officer providing an update to the Integration Joint Board on Discharge Management performance in Dundee.

The Integration Joint Board agreed:-

(i) to note the current position in relation to discharge management performance as outlined in Appendix 1 of the report;

(ii) to note the improvement actions planned to respond to areas of pressure identified; and

(iii) that, future discharge management performance reports be reported through the Performance and Audit Committee.

XVIII DRAFT ANNUAL ACCOUNTS 2016/2017

There was submitted Report No DIJB25-2017 by the Chief Finance Officer presenting the Integration Joint Boards Draft Annual Statement of Accounts 2016/17 for approval to initiate the external audit process.

The Integration Joint Board agreed:-

(i) to the content of the Draft Final Accounts Funding Variations as outlined in Appendix 1 of the report;

(ii) to approve the Draft Dundee Integration Joint Board Annual Corporate Governance Statement as outlined in Appendix 2 of the report;

(iii) to note the Integration Joint Boards Draft Annual Statement of Accounts 2016/17 as outlined in Appendix 3 of the report; and

(iv) to instruct the Chief Finance Officer to submit the Accounts to the Integration Joint Boards External Auditors (Audit Scotland) to enable the audit process to commence.

XIX CONFIRMATION OF DUNDEE INTEGRATION JOINT BOARD 2017/18 BUDGET

There was submitted Report No DIJB26-2017 by the Chief Finance Officer advising the Integration Joint Board that confirmation had been received from Tayside NHS Board of the proposed delegated budget for 2017/18 and seeking approval for acceptance of this budget subject to the risk sharing agreement being applied as set out within the Integration Scheme.

The Integration Joint Board agreed:-

(i) to note the proposed delegated budget from Tayside NHS Board for 2017/18;

(ii) to note that the proposed delegated budget from Tayside NHS Board for 2017/18 was consistent with the Scottish Governments guidance that the delegated budget must be maintained at least at 2016/17 levels;

(iii) to approve the delegated budged proposed by Tayside NHS Board for 2017/18 subject to the adoption of the risk sharing arrangement for Prescribing as outlined in section 4.3 of the report; and

(iv) to note that work continued locally and nationally to establish an appropriate value of the Large Hospital Set Aside and instruct the Chief Finance Officer to bring a report to the Integration Joint Board on this issue at the earliest opportunity.

XX INCORPORATING RISK ASSESSMENT INTO INTEGRATION JOINT BOARD REPORTS

It was reported that a key element of the Integration Joint Board's governance arrangements was the identification, recording and management of risk associated with the business of the Integration Joint Board and delegated services it oversaw. The importance of task assessment and management could be summarised as follows:

- It supports the delivery of strategy and ensures organisational ability to deal with events that may hinder the achievement of corporate objectives

- Provides the platform to improve performance and productivity and identify opportunities

- Fulfils statutory obligations

- Provides stakeholder assurance (e.g. improved focus of assurance activities such as Internal Audit, used as an internal and external communication tool)

- Assists growing and investing in the future through optimising risk based decision making and business planning and better informed, improved decision making

- Assists in cost reduction through reducing the cost of losses by efficient and effective de-risking activity.

The Integration Joint Board had adopted a High Level Risk Register which continued to develop and was monitored by the Performance and Audit Committee. An operational risk register was at the development stage and would also be subject to regular monitoring and review by the Performance and Audit Committee once complete.

In order to ensure risks associated with decisions the Integration Joint Board was being asked to make were appropriately assessed and the implications of these, including mitigation of such risks, were made known to members of the Integrated Joint Board and other stakeholders, it was proposed that an enhanced Risk Assessment section was included in Integrated Joint Board reports. This would cover the following:

Risk Assessment

This would be a mandatory field and a narrative explanation must be provided which covered topics including:

- Risk Description

- Inherent Risk Exposure Rating

- Current Risk Exposure Rating

- Planned Risk Exposure Rating

- Mitigating Actions

- Associated Resources

A recommendation would require to be made to the Integration Joint Board on whether or not to accept the risk. This would ensure that risk management supported, and all stakeholders were appropriately involved in informed decision making.

If it was stated that a risk assessment was not necessary, or had not been undertaken, an explicit explanation of the reasons why this was completed would require to be provided.

These identified risks would subsequently be recorded, or amended, in either the High Level Risk Register of Operational Risk Register as appropriate.

The Integration Joint Board agreed to to approve the revision to the Integration Joint Board Report template as outlined above.

XXI PROGRAMME OF MEETINGS

The Integration Joint Board agreed to note that the programme of meetings of the Integration Joint Board for the remainder of 2017 was as follows:-

Date	Time	Venue
Tuesday, 29th August, 2017	2 pm	Committee Room 1, 14 City Square, Dundee
Tuesday, 31st October, 2017	2 pm	Committee Room 1, 14 City Square, Dundee
Tuesday, 19th December, 2017	2 pm	Committee Room 1, 14 City Square, Dundee

XXII DATE OF NEXT MEETING

The Integration Joint Board agreed to note that the next meeting of the Integration Joint Board would be held in Committee Room 1, 14 City Square on Tuesday, 29th August, 2017 at 2.00 pm.

Ken LYNN, Chairperson.