Dundee City Health & Social Care Integration Joint Board - 26/10/2022

At a MEETING of the DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held remotely on 26th October, 2022.

Present:-

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

Ken LYNN, Chairperson, in the Chair.

I APOLOGIES FOR ABSENCE

Apologies for absence were submitted on behalf of:-

II DECLARATION OF INTEREST

There were no declarations of interest.

III CHAIRPERSONS REMARKS

Prior to Pat Kilpatrick taking the Chair Councillor Ken Lynn paid tribute to the achievements made by the Partnership over the period of his Chairmanship and the work undertaken and that he looked forward to working with the incoming Chair. Pat Kilpatrick echoed these sentiments.

IV CHAIRPERSON AND VICE-CHAIR PERSON

(a) CHAIRPERSON

The Integration Joint Board agreed to note that term of office of Chairperson held by Dundee City Council had lapsed and that in terms of Standing Orders this would now require to be filled by a voting member from NHS Tayside Board.

The Integration Joint Board agreed to note the position and that NHS Tayside Board had nominated Pat Kilpatrick as Chairperson whereupon Pat Kilpatrick took the Chair.

(b) VICE-CHAIRPERSON

The Integration Joint Board agreed to note that term of office of Vice-Chairperson held by NHS Tayside Board had lapsed and that in terms of Standing Orders this would now require to be filled by a voting member from Dundee City Council.

The Integration Joint Board agreed to note the position and that Dundee City Council had nominated Councillor Ken Lynn as Vice-Chairperson.

V PERFORMANCE AND AUDIT COMMITTEE APPOINTMENT OF MEMBERSHIP AND CHAIR

Reference was made to Article VIII of the minute of meeting of the Integration Joint Board held on 30th August, 2016 wherein it was agreed to establish a Performance and Audit Committee as a Standing Committee of the Integration Joint Board. The Terms of Reference were also agreed.

(a) MEMBERSHIP

The Terms of Reference indicated that the Integration Joint Board should appoint the Committee which would consist of not less than six members of the Integration Joint Board. The Committee would include at least four Integration Joint Board voting members (on the basis of two from NHS Tayside and two from Dundee City Council).

The Integration Joint Board noted the position.

(b) CHAIRPERSON

The Committee would be chaired by a person not being the Chairperson of the Integration Joint Board and would be nominated by the Integration Joint Board.

The Integration Joint Board agreed that the membership be on the basis of Councillor Lynn, Councillor Tolland, Councillor McHugh and Sam Riddell who was to replace Donald McPherson as a voting member on the Integration Joint Board and that Councillor Lynn be appointed as Chairperson of the Committee.

VI MINUTE OF PREVIOUS MEETING

(a) The minute of meeting of the Integration Joint Board held on 24th August, 2022 was submitted and approved.

(b) ACTION TRACKER

The Action Tracker DIJB80-2022 for meetings of the Integration Joint Board was submitted and noted.

VII PERFORMANCE AND AUDIT COMMITTEE

(a) MINUTE OF PREVIOUS MEETING OF 28TH SEPTEMBER, 2022

The minute of the previous meeting of the Performance and Audit Committee held on 28th September, 2022 was submitted and noted for information and record purposes.

(b) CHAIRS ASSURANCE REPORT

There was submitted Report No DIJB81-2022 by Pat Kilpatrick, Chairperson of the Performance and Audit Committee, providing an Assurance Report to the Integration Joint Board on the work of the Performance and Audit Committee.

The Integration Joint Board agreed to note the content of the report.

VIII MANAGEMENT OF DELAYED DISCHARGES

There was submitted Report No DIJB75-2022 by the Chief Officer setting out the actions being undertaken to manage and reduce the numbers of delayed discharges attributed to Dundee Health and Social Care Partnership across hospitals in Tayside. Locally, a RAG matrix had been established which laid out the daily position in relation to delayed discharges and the targets agreed. The current position in relation to complex and standard delays in Dundee was 22 and 33 respectively, totalling 55 with a target of 50 by end of October. In relation to the national Urgent and Unscheduled Care Collaborative, measurement of the Tayside Discharge Without Delay rate was also measured on a weekly basis against a target of 98%. Current performance was 97.7% across Tayside.

The Integration Joint Board agreed:-

(i) to note the work being undertaken to address delayed discharges;

(ii) to note the work of the Urgent and Unscheduled Care Board and the associated change projects; and

(iii) to note performance against the Discharge Without Delay indicators remained high at 97.7%.

IX DUNDEE AND ANGUS STROKE REHABLITATION PATHWAY REVIEW

There was submitted Report No DIJB78-2022 by the Chief Officer, providing the Integration Joint Board with an update of progress made to redesign the Dundee and Angus Stroke Rehabilitation Pathway, previously reported to the Integration Joint Board in report DIJB44-2021 on 25th August 2021. The development of the pathway emphasised the support and commitment to delivering effective, high quality, specialist care within the community setting.

The Integration Joint Board agreed:-

(i) to note the redesigned service delivery and financial model of the Inpatient Dundee and Angus Stroke Rehabilitation Pathway as outlined in the report;

(ii) to note the transition of the stroke rehabilitation inpatient beds from Angus to Dundee with establishment of a person centred, stroke specific community rehabilitation pathway which aligned to the national Progressive Stroke Pathway and Tayside patient feedback;

(iii) to note the decommissioning of Ward 7 Stroke at Stracathro Hospital (10 beds); and

(iv) to note the developing plans for the community-based model to be brought to the Integration Joint Board in February 2023.

X DUNDEE PRIMARY CARE IMPROVEMENT PLAN UPDATE

There was submitted Report No DIJB77-2022 by the Chief Officer, providing an update on the implementation of the Dundee Primary Care Improvement Plan for 2021/2022 and seeking approval for the continued implementation of the Dundee Primary Care Improvement Plan for 2022/2023.

The Integration Joint Board agreed:-

(i) to note the progress to implement the Dundee Primary Care Improvement Plan 2021/2022 as detailed in Appendix 1 of the report and the key achievements as detailed in 4.3.3 of the report;

(ii) to approve the proposed actions for Dundee Health & Social Care Partnership for 2022/2023 as described in Appendix 1 of the report and noted the proposed allocation of funding as detailed in Section 3 of the report;

(iii) to note the updated funding position from Scottish Government for 2022/2023 and intended use of Reserves during 2022/2023, as detailed in Section 3 of the report;

(iv) to note that aspects of the Plan were not fully implemented by March 2022, and that practices would receive transitionary payments for services they were still delivering;

(v) to instruct the Chief Officer to issue directions to NHS Tayside to implement the specific actions relevant to them in Appendix 1 of the report;

(vi) to note the previous agreement to delegate the monitoring of the Dundee allocation of the Primary Care Improvement Fund as noted in Section 4.2 of the report; and

(vii) to instruct the Chief Officer to provide a further report on progress made in the forthcoming year of delivering the Dundee Primary Care Improvement Plan to a future Integration Joint Board.

XI GENERAL PRACTICE PREMISES STRATEGY

There was submitted Report No DIJB76-2022 by the Chief Finance Officer setting out the position and ambition for GP premises. It identified the priorities, provided criteria on the management and investment in GP property and included recommendations and actions across the next 20 years.

The Integration Joint Board agreed:-

(i) to approve the Dundee General Practice Premises Strategy as detailed in Appendix 1 of the report;

(ii) to approve the release of 150,000 of funding from reserves to support the establishment of a premises programme manager post over a 22 month period as detailed in section 4.6.5 of the report; and

(iii) instruct the Chief Officer to bring back progress reports to the Integration Joint Board on a six monthly basis.

XII CARERS DELIVERY PLAN AND PERFORMANCE FRAMEWORK

There was submitted Report No DIJB72-2022 by the Chief Officer presenting and seeking approval for the Dundee Carers Strategy Delivery Plan and proposed Performance Framework to the Integration Joint Board.

The Integration Joint Board agreed:-

(i) to note the Delivery Plan as detailed in Appendix 1 of the report as a working document which would be updated on an ongoing basis in response to newly identified opportunities for improvement and development in line with the agreed Carers Strategy A Caring Dundee 2; and

(ii) to approve the Performance Framework as detailed in Appendix 2 of the report which outlined the proposed approach to performance management of services and supports to Carers by Dundee Integration Joint Board.

XIII DUNDEE CITY PLAN 2022/2032

There was submitted Report No DIJB70-2022 by the Chief Officer seeking the Integration Joint Boards endorsement of the Dundee City Plan 2022/2032 following its approval by the Dundee Partnership Management Group on 1st September 2022.

The Integration Joint Board agreed:-

(i) to note the content of the report;

(ii) to endorse the Dundee City Plan for 2022/2032, as detailed in Appendix 1 of the report; and

(iii) to note arrangements that were in place within Dundee Health and Social Care Partnership to support and actively contribute to delivery of priorities and outcomes contained within the Dundee City Plan as detailed in section 4.3 of the report.

XIV STRATEGIC COMMISSIONING PLAN

There was submitted Report No DIJB74-2022 by the Chief Officer updating the Integration Joint Board on the proposed process and timescale for development of a replacement strategic commissioning plan for April 2023 onward, including review of the Boards Equality Outcomes.

The Integration Joint Board agreed:-

(i) to note the content of the report;

(ii) to endorse the proposed approach and timeline for development of a replacement strategic plan and Equality Outcomes as detailed in sections 4.2, 4.3 and Appendix 1 of the report;

(iii) to note the factors that presented a risk to delivery of a replacement strategic commissioning plan that was of a high quality and within the required timescale as detailed in section 4.4 of the report;

(iv) to instruct the Chief Officer to provide a further update on the progress of work to develop the strategic commissioning plan and Equality Outcomes no later than 31st December 2022; and

(v) to instruct the Chief Officer to review and update the strategic risk register to reflect the risk identified in section 6 of the report.

XV FINANCIAL MONITORING POSITION AS AT AUGUST 2022

There was submitted Report No DIJB79-2022 by the Chief Finance Officer providing the Integration Joint Board with an update of the projected financial monitoring position for delegated health and social care services for 2022/2023 including an overview of the costs and financial risks associated with Dundee Health and Social Care Partnerships response to the COVID-19 crisis.

The Integration Joint Board agreed:-

(i) to note the content of the report including the overall projected financial position for delegated services to the 2022/2023 financial year end as at 31st August 2022 as detailed in Appendices 1, 2, and 3 of the report;

(ii) to note the costs and financial risks associated with Dundee Health and Social Care Partnerships continued response to the COVID-19 crisis as detailed in section 4.5 of the report; and

(iii) to note that officers within the Health and Social Care Partnership would continue to carefully monitor expenditure throughout the remainder of the financial year.

XVI IMPLEMENTATION OF THE PUBLIC SECTOR EQUALITY DUTY

There was submitted Report No DIJB71-2022 by the Chief Officer informing the Integration Joint Board of the outcome of audit activity undertaken by the Equality and Human Rights Commission with regard to compliance with the Public Sector Equality Duty, actions taken in response to findings and planned improvements to be undertaken.

The Integration Joint Board agreed:-

(i) to note the content of the report;

(ii) to note the feedback received from the Equality and Human Rights Commission following their recent Integration Joint Board compliance audit, including concerns regarding the sufficiency of information contained within Integration Joint Boards Integrated Impact Assessments as detailed in section 4.2 of the report;

(iii) to note the improvements already made to the publication of the Integration Joint Board equality information and, in partnership with Dundee City Council, to the Integrated Impact Assessment process and tools as detailed in section 4.2.2, 4.3.1 and 4.3.3 of the report;

(iv) to note further planned improvement activity in relation to the completion of Integrated Impact Assessments, including learning and development and quality assurance actions as detailed in section 4.3.5 of the report; and

(v) to instruct the Chief Officer to submit a further report updating the Integration Joint Board on the progress of improvement actions no later than 28th February 2022.

XVII CATEGORY 1 RESPONDER ACTION PLAN

There was submitted Report No DIJB73-2022 by the Chief Officer providing an overview of recent key developments in the implementation of the Integration Joint Boards duties as a Category 1 Responder under the Civil Contingencies Act 2004, and submitting for approval an Integration Joint Board Category 1 Responder Action Plan.

The Integration Joint Board agreed:-

(i) to note the content of the report., including progress made in developing arrangements to support the Integration Joint Board to fulfil their duties as Category 1 Responders as detailed in section 4.2 of the report;

(ii) to approve the Dundee Integration Joint Board Category 1 Responder Action Plan contained within Appendix 1 of the report;

(iii) to instruct the Chief Finance Officer to update the Integration Joint Boards Strategic Risk Register to reflect the current risk level and mitigating actions as detailed in section 6 of the report; and

(iv) to instruct the Chief Officer to submit the first Integration Joint Board Category 1 Responder Assurance Report for 2022/2023 to the Integration Joint Board no later than 30th June 2023.

XVIII MEETINGS OF THE INTEGRATION JOINT BOARD 2022 - ATTENDANCES

There was submitted a copy of the Attendance Return DIJB82-2022 for meetings of the Integration Joint Board held to date over 2022.

The Integration Joint Board agreed to note the position as outlined.

XIX DATE OF NEXT MEETING

The Integration Joint Board agreed to note that the next meeting of the Dundee Integration Joint Board would be held remotely on Wednesday 14th December, 2022 at 10.00am.

Pat KILPATRICK, Chairperson.