Publication

At a MEETING of the DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held at Dundee on 28th February, 2017.

Present:-

Members	Role
Ken LYNN (Chairperson)	Nominated by Dundee City Council (Elected Member)
Stewart HUNTER	Nominated by Dundee City Council (Elected Member)
David BOWES	Nominated by Dundee City Council (Elected Member)
Doug CROSS (Vice Chairperson)	Nominated by Health Board (Non Executive 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
Jane MARTIN	Chief Social Work Officer
Frank WEBER	Registered Medical Practitioner (whose name is included in the list of primary medical performers)
Sarah DICKIE	Registered Nurse
Cesar RODRIGUEZ	Registered Medical Practitioner (not providing primary medical services)
Drew WALKER	Director of Public Health
Raymond MARSHALL	Staff Partnership Representative
Christine LOWDEN	Third Sector Representative
Andrew JACK	Service User Representative
Martyn SLOAN	Carer Representative

Non members in attendance at request of Chief Officer:-

Diane MCCULLOCH	Head of Community Health and Care Services
Douglas LOWDON	Dundee Health and Social Care Partnership
Kathryn SHARP	Dundee Health and Social Care Partnership
Arlene HAY	Dundee Health and Social Care Partnership
David SHAW	Dundee Health and Social Care Partnership
Alan GIBBON	NHS Tayside

Councillor Ken LYNN, Chairperson, in the Chair.

I APOLOGIES FOR ABSENCE

Jim MCFARLANE, Trade Union Representative.

II DECLARATION OF INTEREST

No declarations of interest were made.

III MINUTE OF PREVIOUS MEETING

The minute of meeting of the Integration Joint Board held on 6th December, 2016 was submitted and approved.

IV PERFORMANCE AND AUDIT COMMITTEE

(a) MINUTE OF MEETING OF 17TH JANUARY, 2017

The minute of meeting of the Performance and Audit Committee held on 17th January, 2017 was submitted and noted for information and record purposes, a copy of which is attached to this minute as an appendix.

(b) SUMMARY OVERVIEW

There was submitted an Agenda note by Doug Cross, Chair of the Performance and Audit Committee providing a summary overview following the first meeting of the Performance and Audit Committee which was held on 17th January, 2017 as follows:-

(i) Delegated Decisions taken by the Committee

There were no delegated decisions taken by the Committee at its meeting on 17th January, 2017.

(ii) Performance Against Workplan

The Committee considered the 2016/17 Audit Plan previously approved by the Integration Joint Board. It also scrutinised the Dundee Health and Social Care Partnership Performance Report, noted the outcome of Care Inspectorate inspections and reviewed action plans developed in response to the Audit Scotland Health and Social Care Integration Report and the Annual Internal Audit Report 2015/16. The Committee also reviewed the Partnerships High Level Risk Register.

(iii) Any Other Major Issues to Highlight to the Integration Joint Board

- Good progress has been made in developing and implementing the Partnership's Performance Framework. The Partnership has access to a comprehensive suite of indicators. This provides a new outward approach for benchmarking performance against national data and should assist the Partnership in identifying the key challenges facing it and the actions to be prioritised. Work is in hand to analyse the findings contained within the performance report and actions have been identified to address the key issues and challenges facing the Partnership with associated links to the Partnership's risk register to be made. An Outcomes and Performance Co‑ordination Group is to be established to support further development of the Framework and assist in the production of quarterly and annual performance reports. It was noted future reports would be structured on a locality basis. Further work is to be undertaken in relation to unscheduled care admissions to hospitals and also finalisation of data into respite care.

- The Committee reviewed the Care Inspection reports following inspections at Oakland Day Centre and older people homes Janet Brougham House and Menzieshill House and were pleased to note the grades awarded to the service, the strengths identified within the service and the very positive comments made by servise users and carers. The Committee recorded their appreciation for the contribution and diligence of staff in these establishments in achieving the positive grades and comments.

- The Committee noted the progress made in addressing the issues arising from the Audit Scotland Health and Social Care Integration Report.

- The Committee also noted the progress made against actions arising from the 2015/16 Annual Internal Audit Report.

- The Committee reviewed the current risks and scores contained within the Partnership's High Level Risk Register. The Register will be continually reviewed by the Chief Finance Officer.

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

V DO YOU NEED TO TALK LISTENING SERVICE

Alan Gibbon, Senior Chaplain, NHS Tayside gave a presentation on the aims and objectives of the Listening Service which was a national service being developed in NHS Scotland and its model of support being provided within NHS Tayside. The service was provided in 18 site locations within Dundee primarily based at General Practice Surgeries. The Listening Service was defined as being person centred care which seeks to help people (re) discover hope, resilience and inner strength in times of illness, injury, transition and loss. The listening was an assets based approach, building individual resilience and promoting a sense of well-being and was provided on a one to one basis between the patient and the listener. Sessions may last up to 50 minutes. Patients may present themselves with a range of issues including bereavement, relationship issues, fear/anxiety, loneliness, guilt, drugs/alcohol issues or self esteem/confidence or identity issues. The listeners were volunteers and the national training programme was funded by the Scottish Government. There were currently 11 volunteer listeners in Dundee and over 2015/2016 they saw 211 patients.

The service had been well received by both patients and GPs and was seen to have a positive impact for the better for both the mental and emotional well being of patients and ways to further develop and expand the service were being examined.

The Integration Joint Board welcomed the presentation and noted the content.

VI MEDICINE FOR THE ELDERLY SERVICES

There was submitted Report No DIJB6-2017 by the Chief Officer updating the Integration Joint Board on the progress of work to reshape inpatient, outpatient and community Medicine for the Elderly Services in Dundee to respond to the changing needs and demographics of the population and in line with the strategic direction for older people clinical services of Dundee Health and Social Care Partnership. It was reported that the current and proposed remodelling described within the report would put in place a range of service improvements which would enhance the quality of care afforded to older people and support older people to receive both health and social care closer to home.

The Integration Joint Board agreed:-

(i) to note the progress made and future planned developments in:

- The creation of a specialist stroke rehabilitation unit in Dundee;

- The remodelling of rehabilitation and assessment wards in Royal Victoria Hospital;

- The developments in step down assessment and rehabilitation resources in the community;

- The development of multidisciplinary team working (Enhanced Community Support) in the community; and

- The improved liaison between community services and Ninewells.

(ii) to endorse the principle that any resources released as a result of the proposed changes outlined in the report were reinvested in community based services.

The Integration Joint Board further agreed to note that dialogue was continuing on the staff side and that the Project Team membership would be redrafted as matters progressed towards ensuring the engagement of staff.

VII DUNDEE HOME AND HOSPITAL TRANSITION PLAN UPDATE

There was submitted Report No DIJB2-2017 by the Chief Officer updating the Integration Joint Board of the outcome and progress of actions and arrangements put in place across the Partnership to respond to discharge management.

The Integration Joint Board agreed to note the content of the report and the progress in relation to the Dundee Discharge Management Improvement Plan, a copy of which was attached to the report as an appendix.

The Integration Joint Board further agreed to note that a report on these matters would be submitted together with the Performance Report at future meetings of the Integration Joint Board.

VIII FINANCIAL MONITORING POSITION AS AT DECEMBER 2016

There was submitted Report No DIJB1-2017 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 2016/17.

The Integration Joint Board agreed:-

(i) to note the overall projected financial position for delegated services as at 31 December, 2016;

(ii) to instruct the Chief Finance Officer to continue to monitor the 2016/17 projected financial outturn and to bring to the attention of the Integration Joint Board any areas of concern arising between the December 2016 position and the end of the 2016/2017 financial year;

(iii) to instruct the Chief Finance Officer to seek information from Angus and Perth & Kinross Health and Social Care Partnerships on their plans for cost containment and reduction in relation to overspent services hosted by them on behalf of Dundee Health and Social Care Partnership and to report these back to the Integration Joint Board.

IX FINANCIAL SETTLEMENT 2017/18 OVERVIEW

There was submitted Report No DIJB5-2017 by the Chief Finance Officer providing the Integration Joint Board with an overview of the implications of the Scottish Governments Draft Budget to Dundee Integration Joint Board.

The Integration Joint Board agreed:-

(i) to note the content of the Scottish Governments Draft Budget as it related to health and social care partnerships;

(ii) to note the further transfer of resources from NHS Boards to Integration Authorities to invest in social care of £107m taking the total transfer of resources to support health and social care integration to £357m over 2016/17 and 2017/18;

(iii) to note the potential implications as indicated to Dundee City Health and Social Care Integration Joint Boards delegated budget; and

(iv) to remit to the Chief Finance Officer to bring forward a proposed budget for 2017/18 in relation to delegated services for consideration by the Integration Joint Board.

X NATIONAL HEALTH AND SOCIAL CARE DELIVERY PLAN

There was submitted Report No DIJB7-2017 by the Chief Officer providing the Integration Joint Board with an overview of the recently published national Health and Social Care Delivery Plan, and to set out how requirements relevant to the Health and Social Care Partnership were being addressed.

The Integration Joint Board agreed:-

(i) to note the content of the national Health and Social Care Delivery Plan which was attached to the report as appendix 1 and local arrangements for responding to this;

(ii) to remit to the Integrated Strategic Planning Group to confirm that the detailed commitments made within the delivery plan were fully reflected within the Partnerships Strategic and Commissioning Plan and Strategic Planning Group Commissioning Statements; and

(iii) to remit to the Chief Finance Officer to ensure that future performance reports submitted to the Performance and Audit Committee fully incorporate the local improvement objectives in relation to the six areas of performance as set out at paragraph 4.3.4 of the report.

XI DUNDEE MACMILLAN IMPROVING THE CANCER JOURNEY PROJECT

There was submitted Report No DIJB3-2017 by the Chief Officer updating on the progress of the Dundee Macmillan Improving the Cancer Journey project and outlining the next steps.

The Integration Joint Board agreed to note the progress made and key milestones for the project in 2017 as indicated in the report.

XII CLINICAL, CARE AND PROFESSIONAL GOVERNANCE UPDATE

There was submitted Report No DIJB8-2017 by the Chief Officer informing the Integration Joint Board of the implementation of Getting It Right for Everyone A Clinical, Care and Professional Governance Framework within Dundee Health and Social Care Partnership.

The Integration Joint Board agreed:-

(i) to note the progress made to date as outlined in the report;

(ii) to instruct the Chief Officer to provide exception reporting to every Performance and Audit Committee and six-monthly reports to the Integration Joint Board beginning on 31st October, 2017.

The Integration Joint Board further agreed that a progress report be submitted to the meeting of the Integration Joint Board to be held on 27th June 2017.

XIII DATE OF NEXT MEETING

The Integration Joint Board noted that the next meeting of the Integration Joint Board would be held in Committee Room 1, 14 City Square, Dundee on Tuesday, 25th April, 2017 at 2.00 pm.

Ken LYNN, Chairperson.

At a MEETING of the PERFORMANCE AND AUDIT COMMITTEE OF THE DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held at Dundee on 17th January, 2017.

APPENDIX I

Present:-

Members	Role
Doug CROSS ( Chairperson)	Nominated by Health Board (Non Executive Member)
Stewart HUNTER	Nominated by Dundee City Council (Elected Member)
David BOWES	Nominated by Dundee City Council (Elected Member)
David W LYNCH	Chief Officer
Dave BERRY	Chief Finance Officer
Jane MARTIN	Chief Social Work Officer
Raymond MARSHALL	Staff Partnership Representative

Also in attendance:-

Tony GASKIN	Chief Internal Auditor
Diane McCULLOCH	Dundee Health and Social Care Partnership
Kathryn SHARP	Dundee Health and Social Care Partnership
Lynsey WEBSTER	Dundee Health and Social Care Partnership
Stephen HALCROW	Dundee Health and Social Care Partnership
Anne Marie MACHAN	Audit Scotland

Doug CROSS, Chair, in the Chair.

Prior to commencement of the business the Chair welcomed those in attendance to the first meeting of the Performance and Audit Committee and introductions were made.

I APOLOGIES FOR ABSENCE

Apologies for absence were submitted on behalf of Judith Golden, Dr Cesar Rodriguez and Dr Frank Weber.

II DECLARATION OF INTEREST

No declarations of interest were made.

III PERFORMANCE AND AUDIT COMMITTEE MEMBERSHIP

Reference was made to Article VI of the minute of meeting of the Integration Joint Board held on 25th October, 2016 and Article V of the minute of the meeting of the Integration Joint Board held on 6th December, 2016, wherein the membership of the Performance and Audit Committee was discussed and agreed.

The Committee agreed to note the membership of the Performance and Audit Committee as follows: Doug Cross (Chair); Judith Golden; Councillor David Bowes; Councillor Stewart Hunter; Jane Martin; Dr Cesar Rodriguez or Dr Frank Weber and Raymond Marshall.

IV INTERNAL AUDIT PLAN 2016/17

Reference was made to Article X of the minute of meeting of the Dundee City Health and Social Care Integration Joint Board held on 6th December, 2016 wherein it was agreed to remit to the Performance and Audit Committee to monitor performance against the Internal Audit Plan and to consider recommendations arising from the specific reviews within the plan.

Reference was also made to Article VII of the minute of meeting of Dundee City Health and Social Care Integration Joint Board held on 4th May, 2016 wherein delegated authority was given to the Chief Officer and the Chief Finance Officer to conclude discussions with Fife, Tayside and Forth Valley Management Services and Dundee City Council for the provision of internal audit services for 2016/2017.

There was submitted Report No DIJBPAC2-2017 by the Chief Finance Officer advising the Performance and Audit Committee of the Annual Internal Audit Plan for Dundee City Health and Social Care Integration Joint Board for 2016/2017.

The Committee agreed:-

(i) to note the content of the report and the approved Annual Internal Audit Plan for 2016/17; and

(ii) to note the responsibility placed by Dundee City Health and Social Care Integration Joint Board on the Performance and Audit Committee to monitor performance against the Annual Internal Audit Plan and to consider recommendations arising from the specific reviews within the plan.

The Committee further agreed:-

(iii) to note that a report on the outcome of the Audits listed within the plan at paragraph 4.4 would be submitted to the meeting of the Committee to be held on 20th June, 2017; and

(iv) to note that the Chief Internal Auditor expected to be in a position to submit a report on the Audit Universe towards developing an Audit Strategy congruent with the Risk Register of the Integration Joint Board to the meeting of the Committee to be held on 20th June, 2017.

V DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP PERFORMANCE REPORT

Reference was made to Article IX of the minute of meeting of the Dundee City Health and Social Care Integration Joint Board held on 23rd February, 2016 wherein an outline performance framework and reporting cycle was agreed.

Reference was also made to Article IX and Article X of the minute of meeting of the Dundee City Health and Social Care Integration Joint Board held on 30th August, 2016 wherein it was agreed to establish the Performance and Audit Committee and progress in relation to implementing the Dundee Health and Social Care partnerships performance framework was noted and approved.

There was submitted Report No PAC3-2017 by the Chief Finance Officer updating the Performance and Audit Committee on progress in implementing the Partnership's performance framework. The report also brought forward the Quarter 2 Performance Report for 2016/17 for consideration by the Committee.

The Committee agreed:-

(i) to note the progress that had been made in further developing and implementing the performance framework, and supporting structures and systems, since the last update was provided to the Integration Joint Board on 30th August, 2016;

(ii) to note the intention to establish an Outcomes and Performance Co-ordination Group to support the further development and production of annual and quarterly performance reports;

(iii) to note the performance of Dundee Health and Social Care Partnership as outlined in Appendix 1 of the report; and

(iv) to remit the Chief Finance Officer to further develop the performance report which was appended into a performance improvement plan, including timescales for delivery and appropriate links to the Partnership risk register.

The Committee further agreed:-

(v) to note that paragraph 4.2.1 of the report indicated a new outward approach for benchmarking performance against national data within a clinical and care governance perspective and highlighted the fundamental reasons for the introduction of integrated health and social care services and drew out a range of key areas the Dundee Health and Social Care Partnership needed to focus on to improve outcomes for individuals and communities in the future which would assist in the deployment of resources;

(vi) to note that with reference to paragraph 4.1.10 of the report that a report on the range of data which may be obtained through the Source Team and other services within the Partnership to further support the Dundee Health and Social Care Partnership to identify good practice and improvement activities that may impact positively on outcomes for individuals and communities to assist the work of the Committee and the aims of the Partnership would be submitted to the next meeting of the Committee;

(vii) to note that future reports would be based on reporting on a locality structure basis within Dundee;

(viii) to note that further work would be undertaken in relation to analysis and management of data in relation to unscheduled care admission to hospitals;

(ix) that an update report on the finalisation of data in relation to Respite Care would be submitted to the meeting of the Committee to be held on 20th June, 2017.

VI OUTCOME OF CARE INSPECTORATE INSPECTIONS

There was submitted Report No PAC1-2017 by the Chief Finance Officer advising the Performance and Audit Committee of the outcome of the recent Care Inspectorate inspections of Oakland Day Centre and older people homes Janet Brougham House and Menzieshill House.

The Committee agreed:-

(i) to note the content of the report and the content of the inspection reports which were attached as to the report as appendices 1, 2 and 3;

(ii) to note the one recommendation for Menzieshill House as outlined in paragraph 4.3.5 of the report; and

(iii) to note the grades awarded to the service, the strengths of the service, and the very positive comments made by service users and carers.

The Committee further agreed:-

(iv) to note that contact would be made with the Care Inspectorate in relation to policy issues in relation to the PVG scheme; and

(v) to record their appreciation for the contribution and diligence of staff within the Partnership with responsibility for the individual services referred to in the report towards achieving positive reports from the inspections carried out by the Care Inspectorate.

VII AUDIT SCOTLAND HEALTH AND SOCIAL CARE INTEGRATION REPORT - ACTION PLAN UPDATE

Reference was made to Article VII of the minute of meeting of the Dundee City Health and Social Care Integration Joint Board held on 23rd February, 2016 wherein the content of Audit Scotlands report on progress made in establishing the new Integration Joint Boards following the implementation of the Public Bodies (Joint Working) (Scotland) Act 2014 which was published in December 2015 was noted and the action plan to be adopted locally in order to mitigate the identified risks for Dundee Health and Social Care Partnership was set out.

There was submitted Report No PAC5-2017 by the Chief Finance Officer providing an update to the Performance and Audit Committee of the actions identified to mitigate the risks highlighted by Audit Scotland following their review of Health and Social Care Integration in December 2015.

The Committee agreed to note the progress of the key actions identified as a response to the recommendations arising from the Audit Scotland Report on Health and Social Care Integration.

The Committee further agreed to note that a development session around governance would be arranged for the membership of the Integration Joint Board to assist their awareness and understanding of governance issues later in the year.

VIII ANNUAL INTERNAL AUDIT REPORT 2015/16 ACTIONS UPDATE

Reference was made to Article VI of the minute of meeting of the Dundee City Health and Social Care Integration Joint Board held on 28th June 2016 wherein the content of the Annual Internal Audit report on the internal control framework for the Integration Joint Board for the financial year 2015/2016 was noted and it was agreed that an action plan be developed in relation to address areas recommended for improvement.

There was submitted Report No PAC4-2017 by the Chief Finance Officer updating the Performance and Audit Committee of progress in responding to the required actions highlighted within the Chief Internal Auditor's Annual Internal Audit Report 2015/16.

The Committee agreed:-

(i) to note the progress made against the actions highlighted in Appendix 1 of the report; and

(ii) to remit the Chief Finance Officer to bring a further progress report to the Performance and Audit Committee to conclude the 2015/16 action plan.

IX HIGH LEVEL RISK REGISTER - UPDATE

Reference was made to Article VIII of the minute of meeting of the Dundee City Health and Social Care Integration Joint Board held on 30th August 2016 wherein the High Level Risk Register for the Integration Joint Board was approved.

There was submitted Report No PAC6-2017 by the Chief Finance Officer updating the Performance and Audit Committee of the status of Dundee Health and Social Care Partnership's High Level Risk Register.

The Committee agreed:-

(i) to note the current risk levels associated with the risk categories as set out in Appendix 1 of the report; and

(ii) to remit the Chief Finance Officer to continually review the risk register in line with any areas of concern identified within future Dundee Health and Social Care Partnership performance reports.

X PROGRAMME OF MEETINGS 2017

The Committee agreed that the programme of meetings of the Performance and Audit Committee for the remainder of 2017 be as follows:-

Date	Venue	Time

Tuesday, 14th March, 2017	Committee Room 1, 14 City Square, Dundee	2.00 pm
Tuesday, 20th June, 2017	Committee Room 1, 14 City Square, Dundee	2.00 pm
Tuesday, 12th September, 2017	Committee Room 1, 14 City Square, Dundee	2.00 pm
Tuesday, 28th November, 2017	Committee Room 1, 14 City Square, Dundee	2.00 pm

XI DATE OF NEXT MEETING

The Committee noted that the next meeting of the Committee would be held in Committee Room 1, 14 City Square, Dundee on Tuesday, 14th March, 2017 at 2.00 pm.

Doug CROSS, Chairperson.