Fife Health & Social Care Shadow Joint Board Tuesday 4 th August 2015 09.00 11.30hrs Conference Room 1, Ground Floor West, Fife House Present: Ms Alison Rooney, NHS Fife, Chair Cllr Andrew Rodger, Fife Council, Co-Chair Mr Sandy Riddell, Director of Health and Social Care Mrs Janice Cameron, Development Officer, Scottish Care Ms Helen Paterson, Director of Nursing, NHS Fife Ms Rona King, Deputy Chief Executive, NHS Fife Dr Frances Elliot, Medical Director, NHS Fife Mr Simon Little, NHS Fife Mr John Paterson, NHS Fife Ms Tina Chapman, Chair Public Reference Group Cllr Gavin Yates, Fife Council Cllr Dorothea Morrison, Fife Council Dr Les Bisset, NHS Fife Ms Rona Laing, NHS Fife Cllr John Docherty, Fife Council Cllr David Ross, Council Leader Cllr Judy Hamilton, Fife Council Cllr Neale Hanvey, Fife Council In Attendance: Mrs Heather Ford, Integration Change Manager, Fife Council Mr Iain Matheson, Head of Legal Services, Fife Council Ms Debbie Thompson, Joint Trades Unions Secretary Apologies: Mr Allan Burns, Chairman, NHS Fife Mrs Wilma Brown, Employee Director, NHS Fife Cllr Tim Brett, Fife Council Mr Paul Hawkins, Chief Executive, NHS Fife Mr Kenny Murphy, Fife Voluntary Action Mr Steve Grimmond, Chief Executive, Fife Council Mrs Fiona Mackenzie, Integration Change Manager, NHS Fife Minute Taker: Kerry Elliott, Secretary to Sandy Riddell, Director of Health & Social Care 1.
1. Apologies ACTION Apologies noted as detailed above. 2. Previous Minutes Previous minutes approved. 3. Matters Arising No matters arising. 4. Monitoring Report/ Gantt Chart Mrs Ford introduced the report which highlights the key tasks, prior commitments and relevant deadlines covered in the period 10 th June to 22 nd July 2015. Mrs Ford advised that items 4a and 4b should be read together. Item 4a provides detailed Gantt information and item 4b provides the timeline associated with this activity. In relation to the request to feature a RAG status indicator on the Gantt Chart, Mrs Ford advised that unfortunately the Microsoft Office Project package used to populate the Gantt Chart did not allow that function. Mrs Ford stated that the schedule of meeting dates for 2016 were currently being worked on, taking into consideration arrangements already in place in both Fife Council and NHS Fife s corporate calendar. Mrs Ford stated that a business plan would be devised once the 2016 dates had been confirmed. Ms Laing raised concern in relation to the business plan and queried whether reports would be brought to Board meetings scheduled to take place in 2015 or whether the Board would not be sighted on any reports until 2016. Mr Riddell advised that outstanding reports would be tabled at both the formal meetings of the Board in September and October 2015. Ms Laing also requested the schedule to include progress, performance and update reports which would have previously gone to e.g. the Health and Social Care Partnership to be included. For clarity, Ms Rooney suggested that the business plan described should be referred to, going forward, as a schedule of committee business. Ms Rooney requested that the schedule of committee business be drafted and brought to the formal meeting of the Board 2.
on 24 th September 2015. On behalf of the Board Ms Rooney reflected on the amount of work carried out and formally thanked the team. ACTION: Mr Riddell s office to draft a schedule of committee business to be circulated and discussed at the formal meeting of the Board on 24 th September 2015. Mr Riddell s office to coordinate outstanding reports for discussion at the September and October 2015 meetings of the Board. SR/HF 5. Integration Scheme - Revised Mr Matheson advised that, as requested by the Board at the June meeting, the Governance work stream had revised the Integration Scheme, taking into consideration comments made. In relation to the revised version of the Integration Scheme, Mr Matheson confirmed that, as requested, informal discussions with Civil Servants had taken place. Mr Matheson advised that feedback from Civil Servants had intimated that if the Integration Scheme were to be submitted in its current form, they were confident that it would be approved. Mr Matheson advised that Mr Riddell had held a meeting with relevant colleagues to discuss Clinical and Care Governance, and the reporting lines of the Clinical and Care Governance Committee and its relationship to the Integration Joint Board, Fife Council s Scrutiny Committee and the NHS Fife Board. Mr Matheson stated that colleagues felt that the Clinical and Care Governance Committee should report to the Integration Joint Board directly and that the Integration Joint Board would report to Fife Council s Scrutiny Committee and the NHS Fife Board. Mr Matheson stated that he had contacted Ms Alison Taylor, Scottish Government to seek advice on changing the reporting lines who advised that as the Integration Joint Board was a legal entity in its own right, the Clinical and Care Governance Committee would require to report separately to the Integration Joint Board, Fife Council s Scrutiny Committee and the NHS Fife Board. Dr Elliot explained the rationale behind the changing of the reporting lines stating that as the Integration Joint Board would be held accountable, the Integration Joint Board would require to be informed before the parent bodies. For clarity, Ms Rooney requested that Mr Matheson and Dr Elliot contact Ms Taylor, Scottish Government, to further discuss the rationale for changing the reporting relationship from that described in the Integration Scheme at present. On behalf of the Board, Ms Rooney confirmed that the Integration Scheme should not be amended, prior to submission, if Ms Taylor expressed concern in relation to any suggested amendments. 3.
ACTION: Mr Matheson and Dr Elliot to contact Ms Taylor to further discuss reporting lines of the Clinical and Care Governance Committee. Integration Scheme to be submitted once position clarified. IM In relation to pg. 37, appendix 1 of the Integration Scheme, Mr Matheson stated that Mr Dougie Dunlop, Chief Social Work Officer, Fife, had requested that wording be amended to: In addition to the functions that must be delegated, Fife Council has chosen to delegate the functions listed in Part 1A as they relate to Adult Social Work Services provided to persons aged 16-18 years. Mr Riddell confirmed that this amendment did not present any issue for the Partnership and reflected the structuring of Services in Fife. Mr Riddell highlighted that this amendment/clarification was important with regard to the forthcoming Children s Services Inspection. On behalf of the Board, Ms Rooney confirmed the Board s contentment to amend the wording as requested by Mr Dunlop. Ms Rooney requested that Mr Matheson seek an update on the likely timescale in relation to being advised of the Scottish Government s approval of the resubmitted Integration Scheme. ACTION: Mr Matheson to contact Civil Servants to request the likely timeframe for approval of resubmitted Integration Scheme. IM 6. Development of the Draft Strategic Commissioning Plan for Fife In relation to the previously circulated covering report and supporting appendices, Mr Riddell introduced the report and summarised the requests made by Board Members to date to allow the first draft of Fife s Strategic Commissioning Plan to be presented to the Board in its entirety at today s meeting. Mr Riddell emphasized that the Strategic Commissioning Plan was not a delivery or operational plan and confirmed that its purpose was to evidence Fife s Strategic priorities and commissioning intentions to meet the National Health and Wellbeing Outcomes. Mr Riddell advised Board Members to ensure that any feedback in relation to the first draft be sent directly to Ms Teresa Briggs by close of play Friday 14 th August. Mr Riddell highlighted that the Strategic Commissioning Plan would need to be available by the end of September to allow for the 3-month consultation period to take place and to be signed off at a meeting of the Board in February/March 2016. Mr Riddell asked the Board to comment on whether they wished another session to be organised in advance of the Formal Board meeting on the 24 th September, to have a final run through of the Strategic Commissioning Plan, before formally signing off the 4.
document at the Board meeting on the 24 th September. Mr Riddell stressed that the purpose would not be to amend or re write sections of the Plan already approved, but to ensure that colleagues were content with the flow and additions made following comments received. Mr Riddell reminded colleagues that following the consultation process, the Strategic Commissioning Plan would be able to be amended to take into consideration any comments made or revisions required. Ms Briggs advised that the draft Strategic Commissioning Plan was an evolving document, which would continue to be reviewed and amended by members of the Strategic Commissioning Planning Group. Ms Briggs advised that the Strategic Commissioning Planning sub-group was meeting on a weekly basis at present to work through the document and confirmed that the group was on track to complete the document within the timescales set. Ms Briggs stated that some information, now provided by 3 rd sector, required to be incorporated into the Strategic Commissioning Plan and in addition advised that the group had not focused on the presentation and layout of the document at this stage. Ms Briggs advised that, once finalised, the document would be sent to a small group of colleagues for proofreading and rectification of any grammatical or formatting issues. Mr Riddell stated that the huge amount of work that had been done had been recognised at the last meeting of the Strategic Commissioning Planning Group and that the group were committed to the process which had been very inclusive. Mr Riddell stated that Ms Christina Naismith, JIT, and advisor to Fife s Strategic Commissioning Planning Group, had provided good feedback in relation to the work carried out by the Strategic Commissioning Planning Group and progress made to date. Cllr Rodger queried why the foreword had been signed off by the two Chief Executives and not Fife s Chief Officer. Cllr Rodger raised concern that this did not symbolise the Partnership coming together into one Board, with one name and a joint appointment of a Chief Officer for the Partnership. Cllr Ross echoed Cllr Rodger s concern in relation to the foreword and asked for confirmation of what had happened in other areas. Mr Riddell advised that it was his understanding that the Chief Officer to the Integration Joint Board had signed off the Strategic Commissioning Plan in other areas. Ms Ford advised that Ms Naismith had felt strongly that the foreword should be signed off by the Chief Officer of the Integration Joint Board and not the Chief Executives of the parent bodies. 5.
Ms Rooney suggested that the foreword should be signed by both the Chief Officer and the Chair of the Integration Board. ACTION: Ms King to feedback to Mr Hawkins on his return in relation to the foreword of the Strategic Commissioning Plan. RK Ms Laing expressed her contentment in receiving the document in its entirety and suggested that the locality appendix within the Integration Scheme be used as a useful tool in planning the engagement consultation. Mr Little stated that the document was a good document but raised concern in relation to the level of detail under section 9.9 of the Strategic Commissioning Plan in relation to finance. Mr Riddell advised that there was still a huge amount of work to be done in relation to finances and confirmed that no other Board had included any further detail than what was included under section 9.10 of Fife s Strategic Commissioning Plan. In conjunction, Dr Elliot stated that the Board needed to see how the Partnership worked in an integrated way first to identify efficiencies. Dr Elliot stated that the information Mr Little was looking for was much further into the process. Dr Bisset stated that there was a need to emphasize that the local delivery plans would show where resources would be released. Dr Bisset requested that Ms Briggs ensured that the Strategic Commissioning Plan was aligned to the NHS Board Strategic Framework. In relation to performance framework, Cllr Hanvey stated that he hoped to see this as a trend/theme throughout the document and not at the end of the document, so to promote and evidence the strategic development at a high level. In relation to section 8, Transforming Services, Cllr Hanvey stated it would be helpful to show what the key outcomes were to help readers understand where the risks and opportunities lie. Cllr Ross requested that the terminology be consistent throughout the document and future reports in relation to whether the document is Fife s Strategic Commissioning Plan or Fife s Commissioning Plan. Cllr Ross stated that he had met with Mr Burns, Mr Hawkins and Mr Grimmond to discuss finances and advised that a date was currently being sought to meet with the Cabinet Secretary to follow up previous discussions in relation to funding for the Partnership. On behalf of the Board, Ms Rooney summarised that on the whole feedback in relation to the Strategic Commissioning Plan was positive but some Board members would welcome an additional 6.
session to be walked through the final document for the purpose of clarifying any sections that were not understood. Ms Rooney stated that the Board would wish to be sighted on the set of consultation documents also at the extra meeting. Ms Rooney requested Mr Riddell to organise an additional session as close to the 24 th September Board as possible to allow the Board to receive the final documents in advance of the meeting. Ms Rooney requested that Board members confirm their intention to attend the session once the date was set and papers had been circulated. ACTION: Mr Riddell s office to organise additional meeting of the Board in advance of the 24 th September 2015. SR 7. Performance Framework In relation to the previously circulated report, Ms McCallion and Mrs McKay summarised the content and findings of the report in relation to the performance and activity presented within the Interim Performance Report. Ms McCallion confirmed that the report was an interim report which would evolve with the development of a Partnership performance framework and further development of the core indicators which underpin the Health and Wellbeing Outcomes for Integration. Ms McCallion and Mrs McKay requested that the Board comment on potential content to be included in future Interim Performance reports. Dr Bisset welcomed the report and queried whether other services under the authority of the Board, not currently listed, would be appropriately reported on. Dr Bisset stated it would be helpful to include a trajectory of emergency admissions. Ms Laing stated that the document was a good document and welcomed the data. In relation to the care grades, Ms Laing suggested that the Quality Assurance team do a presentation at a future development session to help explain the grading to Board members. Ms Laing also queried whether the performance reporting would sit with the Clinical and Care Governance Committee in the future. Ms Paterson recognised the vast data included in the report but highlighted that it should be linked to the Strategic Priorities to eliminate the risk of not delivering. Ms Paterson suggested that data should be linked under the priority headings. Cllr Hanvey stated that it was important to recognise the purpose of the report and queried how the Board would now use the information gathered. Cllr Hanvey stated that there was a need to explore the 7.
good and bad in relation to both the strategic and operational element. Cllr Hanvey requested information in relation to waiting lists to be included in future reports. Ms McKay confirmed that the Chief Executive, Fife Council, had requested the information in relation to waiting lists also and confirmed the detail would be included in future performance reports. Mr Little welcomed the report and stated that it would be helpful if future reports were based around the localities. Mr Riddell confirmed that the local delivery plans and performance arrangements would be tracked by the Senior Leadership Team. Mr Riddell advised that the performance report would act as a formal audit trail. Mr Riddell advised that once the Partnership s performance framework was established, then reporting would be made by exception to the appropriate sub-committees, and the Integration Joint Board would have an overview of trends. On behalf of the Board, Ms Rooney welcomed the report and the level of the detail contained therein. Ms Rooney stated that for future reports, the Board should be asked to discuss not just note the content of the report. 8. Workforce Plan Ms Hutchins attended the Board to present the Workforce Plan, as previously circulated. Ms Hutchins stated that the work plan was a draft that required to be discussed more widely as, at present, involvement had been limited to those in the workstream group. Mr Riddell stated that the purpose of the report was to reassure members of progress in relation to: The establishment of the workforce development group. Identifying potential tests of change to be piloted. Discussions with relevant staff and colleges in relation to the establishment of a multi-skilled frontline worker. Mr Riddell advised Ms Hutchins that the workplan needed to be completed by March 2016 and stressed that work in this area needed to be accelerated. Cllr Docherty raised concern in relation to there being no mention of equality within the Workforce Plan. Cllr Docherty stated that this was an important responsibility of both Fife Council and NHS Fife and suggested that this be brought under short-term actions. 8.
Cllr Hanvey queried how policies would be harmonised in relation to staffing disciplinary and investigations. Ms Hutchins confirmed that HR colleagues recognised issues in relation to policies and advised that an action plan would be devised based on guidance received by the Scottish Government. In relation to the recommendations, Ms Rooney confirmed that the Board noted the report and acknowledged that there would be reports in relation to the Workforce Plan tabled at future Board meetings. 9. Public Participation and Engagement In relation to the previously circulated report, Ms Ewing confirmed that the purpose of the paper was to update the Shadow Integration Joint Board on the development of a Participation and Engagement Strategy for the Fife Health and Social Care Partnership. Ms Ewing stated that this had been an exciting piece of work and that comments fed back were detailed in Appendix 1 of the report. The Board were asked to note the progress on the work being undertaken to identify a future model and strategy for Public Participation and Engagement in Fife and to note that further reports would be submitted on completion of this work. Dr Elliot welcomed the document. Dr Elliot confirmed that there was already engagement in relation to potential Tests of Change and emphasized that it was important to engage with the communities involved in relation to the Tests of Change as it would show how inclusive and responsive the Partnership was being. Mr Little suggested that there was a role for facilitation by the Independent Sector. Ms Ewing acknowledged this comment and advised that this would need to be considered going forward. Ms Rooney advised that she was not clear specifically on how Participation and Engagement for services on the Integration Joint Board would work in relation to those for services retained by the NHS Board and requested clarification in relation to the whole approach across the health and social care system. Mr Riddell stated that there was a need for a clear landscape to ensure no duplication. Mr Riddell stated that it would be helpful to see the landscape in order to make decisions on areas that required to be developed or the current remit changed. 9.
Dr Bisset confirmed that NHS Fife was currently reviewing the role of the Public Engagement Committee which would aid in clarifying the landscape. The Board accepted the recommendations as detailed in the report. 10. Draft Risk Register for Integration Joint Board and Programme Risk Register Mr McDonald and Ms Sweeney attended the Board to answer questions from Board members in relation to the previously distributed Risk Register for the Integration Board and the Programme Risk Register. Ms Rooney stated that there were a lot of mitigating actions in the Risk Register that would need to feature in the forward planning section of the Integration Joint Board monitoring report to provide comfort that they were being addressed. Dr Elliot stated that the risk registered highlighted the need for the parent bodies to marry up and synchronise. Mr McDonald advised that there was a need for the Integration Joint Board to be aware of risks from NHS Fife and Fife Council. Ms Rooney stated that it was essential that the Board properly reviews the risk register, especially the red risks, and requested that the agenda for the next and future meetings be amended to allow sufficient time for full discussion ACTION: Mr Riddell s office to ensure that the risk register featured higher on the agenda at future Board meeting and that sufficient time is allocated to allow Board members to fully discuss the red risks. SR 11. Finance Update Ms Carter attended the Board to present the previously circulated finance update to the Board. Ms Carter clarified that, due to the timing of the Board, the report only detailed the financial position within NHS Fife as it was not possible to report on Fife Council s financial position at this time. Ms Carter provided a summary of overspends, emphasising that the majority of theoverspends highlighted were due to the use of agency and bank staff. Ms Carter advised that work was currently ongoing in relation to reducing the use of agency and bank staff and stated that the expectation is that finances would recover. Ms Carter advised that work was almost complete in relation to realigning services into the three divisions. Ms Carter advised that, from the end of July onwards, Divisional General Managers and the 10.
12. AOCB Board would receive reports based on reporting from each of the three divisions. Ms Carter advised that the next key step was around financial assurance and that a report was currently being drafted, which would be shared with internal audit, before being scheduled for discussion at the September Shadow Joint Board. Ms Carter confirmed that local financial regulations were currently being agreed and that once work was completed, a report would come to a future Board meeting. On behalf of the Board, Ms Rooney thanked Ms Carter for providing a detailed written report. In relation to the previously circulated Save the Date email sent with regard to the Integration Conference, scheduled to take place on the 3 rd February 2016, Mr Riddell confirmed that a planning group had been established and it was his intention to bring back a draft programme to the September Board for consideration. Ms Rooney queried whether funds had been identified for the Integration Conference. Mr Riddell confirmed that there was money set aside from the Organisational Development Fund, which would be utilised. Mr Riddell confirmed that his initial thoughts included a formal launch of the Partnership on the 3 rd February 2016, although clarifying that not all services would be devolved into the Partnership until the following month. Board members expressed their contentment with regards to the Integration Conference and Ms Rooney confirmed that Board members looked forward to receiving an outline of the Conference Programme at the September Board meeting. Mr Riddell advised that a request had been received from a group of 10 Health and Social Care executives from Denmark to spend a day in Fife (15th Sept) as part of a three-day visit to Scotland to learn from what Fife is doing. Mr Riddell stated that it would also be a good opportunity to engage and learn from their work. Mr Riddell advised that the delegation is made up of a mix of politicians, directors and staff leaders from Health and Social care, who are keen to meet some of Fife s Board members. Mr Riddell advised that he would circulate information in relation to their visit and requested that Board Members consider and advise of their intention to participate. 11.
ACTION: Mr Riddell s office to circulate details of the Danish delegate s visit to Fife for their consideration. SR 12.