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Publication

At a MEETING of the DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held remotely on 26th March, 2021.

Present:-

Members

Role

 

Ken LYNN (Chairperson)

Nominated by Dundee City Council (Elected Member)

Trudy McLEAY (Vice Chairperson)

Nominated by Health Board (Non-Executive Member)

Lynne SHORT

Nominated by Dundee City Council (Elected Member)

Helen WRIGHT

Nominated by Dundee City Council (Elected Member)

Donald McPHERSON

Nominated by Health Board (Non-Executive Member)

Vicky IRONS

Chief Officer

Dave BERRY

Chief Finance Officer

Diane McCULLOCH

Chief Social Work Officer

Krista REYNOLDS (for Wendy REID)

Registered Nurse

Jim McFARLANE

Trade Union Representative

Linda GRAY

Service User Representative

Martyn SLOAN

Carer Representative

James COTTON

Registered Medical Practitioner (not providing primary medical services)

Eric KNOX

Third Sector Representative

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

Christine JONES

Dundee Health and Social Care Partnership

Jenny HILL

Dundee Health and Social Care Partnership

Ken LYNN, Chairperson, in the Chair.

I APOLOGIES FOR ABSENCE

Apologies for absence were submitted on behalf of:-

Members

Role

Jenny ALEXANDER

Nominated by Health Board (Non-Executive Member)

Emma FLETCHER

Director of Public Health

Wendy REID

Registered Nurse

Raymond MARSHALL

Staff Partnership Representative

II DECLARATION OF INTEREST

There were no declarations of interest.

III MINUTE OF PREVIOUS MEETING

The minute of meeting of the Integration Joint Board held on 24th February, 2021 was submitted and approved subject to the following amendments:-

(i)                            that the sederunt be amended to reflect that Lynne Short was present;

(ii)                           that sentence at Article VIII(v) be replaced with to note that evaluation by users of the service would be included in the next report;

 

(iii)                          that wording at Article X be added as follows (vii) to note that the Chief Finance Officer would look to provide more breakdown information in reports in relation to the Older Peoples Service in the longer term; and

 

(iv)                          that wording at Article (XII)(iv) be added to the end of that sentence as follows following question from Councillor Short in relation to the process of Cora Funding.

IV DUNDEE INTEGRATION JOINT BOARD PROPOSED BUDGET

 

There was submitted Report No DIJB9-2021 by the Chief Finance Officer advising the Integration Joint Board of the implications of the proposed delegated budget for 2021/2022 from Dundee City Council and indicative budget from Tayside NHS Board and to seek approval for the range of savings required to set a balanced budget for Dundee Health and Social Care Partnership for 2021/2022.

 

The Chief Finance Officer further reported on the recent Scottish Government Announcement in relation to the application of national uplift to third party contracts and explained that this had had an impact on the content of the report and in this respect requested that the Integration Joint Board agreed to note adjustment to the report to reflect recent national direction in relation to payment of the living wage as follows:-

 

Current recommendation at 2.5 be replaced with the following:-

 

2.5  Approves an uplift of 2.2% for 2021/2022 to rolling contractual arrangements with the third and independent sector for the provision of health and social care services where living wage is a feature in line with the Scottish Government's policy to ensure all adult social care workers receive an uplift for the Scottish Living Wage and approves an uplift of 1.7% for all other contracts where living wage is not a feature.

 

Further Recommendation be added as follows:-

 

2.8 Instructs the Chief Finance Officer to report back to the Integration Joint Board on the implications to the Integration Joint Board's budget should the additional funding received by the Integration Joint Board to implement the national living wage policy vary from the anticipated cost.

 

Paragraph 4.7.2 of the report be replaced with the following:-

 

4.7.2 Care providers continue to face a number of financial challenges and in recognition of this and the important contribution the services they provide make to the overall health and social care service landscape.  For most providers, the Scottish Governments commitment to pay the Scottish Living Wage will be a factor in their increased cost base and it is proposed to recognise this increase and fully implement the Scottish Government's direction to apply a 2.2% increase to current contractual arrangements where living wage is applicable (not including the National Care Home Contract). It is further proposed to increase all other non-living wage contractual arrangements by 1.70% despite the scale of financial savings required to be made by the Integration Joint Board. This would result in an additional cost of approximately £611k. 

Thereafter, following questions and answers and having heard the Chief Finance Officer, the Chair seconded by Councillor Short moved that the Integration Joint Board agreed:-

(i) to note the implications of the proposed delegated budget to Dundee Health and Social Care Partnership from Dundee City Council and indicative delegated budget from Tayside NHS Board for 2021/2022 as set out in sections 4.2 and 4.5 of this report;

 

(ii) to approve the delegated budget proposed by Dundee City Council as set out in section 4.5 and Table 2 within this report;

(iii) to instruct the Chief Finance Officer to report back to the Integration Joint Board following receipt of formal notification from Tayside NHS Board of the budget offer with associated recommendations including any implications of the finalisation of hosted services budgets and the Large Hospital Set Aside on the Integration Joint Boards net budget position and associated savings;

(iv) to note the range of estimated cost pressures and funding uplifts anticipated to impact on the Integration Joint Boards 2021/22 delegated budget (Appendix 1);

(v) to approve an uplift of 2.2% for 2021/2022 to rolling contractual arrangements with the third and independent sector for the provision of health and social care services where living wage is a feature in line with the Scottish Government's policy to ensure all adult social care workers receive an uplift for the Scottish Living Wage and approves an uplift of 1.7% for all other contracts where living wage is not a feature;

 

(vi) to approve the range of savings set out in the attached Savings Proposal Report (Appendix 2) in order to bring the projected budget position closer to balance;

 

(vii) to remit the Chief Finance Officer to issue directions as set out in Section 8 of the report;

 

(viii) to Instruct the Chief Finance Officer to report back to the Integration Joint Board on the implications to the Integration Joint Board's budget should the additional funding received by the Integration Joint Board to implement the national living wage policy vary from the anticipated cost; and

 

(ix) to note that paragraph 4.7.2 of the report had been replaced with the following:-

 

4.7.2 Care providers continue to face a number of financial challenges and in recognition of this and the important contribution the services they provide make to the overall health and social care service landscape.  For most providers, the Scottish Governments commitment to pay the Scottish Living Wage will be a factor in their increased cost base and it is proposed to recognise this increase and fully implement the Scottish Government's direction to apply a 2.2% increase to current contractual arrangements where living wage is applicable (not including the National Care Home Contract). It is further proposed to increase all other non-living wage contractual arrangements by 1.70% despite the scale of financial savings required to be made by the IJB. This would result in an additional cost of approximately £611k.

 

As an amendment Bailie Helen Wright seconded by Jim McFarlane moved:-

 

(i) to note the implications of the proposed delegated budget to Dundee Health and Social Care Partnership from Dundee City Council and indicative delegated budget from Tayside NHS Board for 2021/2022 as set out in sections 4.2 and 4.5 of this report;

 

(ii) to approve the delegated budget proposed by Dundee City Council as set out in section 4.5 and Table 2 within this report;

(iii) to instruct the Chief Finance Officer to report back to the Integration Joint Board following receipt of formal notification from Tayside NHS Board of the budget offer with associated recommendations including any implications of the finalisation of hosted services budgets and the Large Hospital Set Aside on the Integration Joint Boards net budget position and associated savings;

(iv) to note the range of estimated cost pressures and funding uplifts anticipated to impact on the Integration Joint Boards 2021/22 delegated budget (Appendix 1);

(v) to approve an uplift of 2.2% for 2021/2022 to rolling contractual arrangements with the third and independent sector for the provision of health and social care services where living wage is a feature in line with the Scottish Government's policy to ensure all adult social care workers receive an uplift for the Scottish Living Wage and approves an uplift of 1.7% for all other contracts where living wage is not a feature;

 

(vi) to approve the range of savings set out in the attached Savings Proposal Report (Appendix 2) in order to bring the projected budget position closer to balance;

 

(vii) to remit the Chief Finance Officer to issue directions as set out in Section 8 of the report;

 

(viii) to Instruct the Chief Finance Officer to report back to the Integration Joint Board on the implications to the Integration Joint Board's budget should the additional funding received by the Integration Joint Board to implement the national living wage policy vary from the anticipated cost;

 

(ix) to note that paragraph 4.7.2 of the report had been replaced with the following:-

 

4.7.2 Care providers continue to face a number of financial challenges and in recognition of this and the important contribution the services they provide make to the overall health and social care service landscape.  For most providers, the Scottish Governments commitment to pay the Scottish Living Wage will be a factor in their increased cost base and it is proposed to recognise this increase and fully implement the Scottish Government's direction to apply a 2.2% increase to current contractual arrangements where living wage is applicable (not including the National Care Home Contract). It is further proposed to increase all other non-living wage contractual arrangements by 1.70% despite the scale of financial savings required to be made by the IJB. This would result in an additional cost of approximately £611k; and

 

(x) Given the £2.658m shortfall shown in the currently predicted budget, the Joint Board instructs the Chair to write to the Leader of Dundee City Council to request that (a) the £778,000 that the Council top sliced from funding allocated to Health be released to the Joint Board forthwith, and (b) the Council should also provide the Joint Board with detailed reasons why they have seen fit to top slice £778,000 from the 2021/2022 and £1.6m from the 2020/2021 allocations.

 

On a division there voted for the motion:- The Chair, Trudy McLeay, Councillor Lynne Short and Donald McPherson (4); and for the amendment:- Bailie Helen Wright (1), whereupon the motion was declared carried.

 

Following questions and answers the Integration Joint Board further agreed:-

 

(xi) to note that work would be ongoing with the Carers Partnership over the next financial year;

 

(xii) to note the explanation from the Chief Finance Officer in relation to the position outlined in the report regarding Staff Turnover, Carers Funding and Adult Social Care Funding;

 

(xiii) to note that a review of home working arrangements would be undertaken in the coming months; and

 

(xiv) to note the position in relation to social prescribing as outlined by Trudy McLeay and that link workers were now in place in all 29 GP Practices in Dundee and the achievements made in this regard.

 

V 5 YEAR FINANCIAL FRAMEWORK

There was submitted Report No DIJB10-2021 by the Chief Finance Officer providing the Integration Joint Board with a forecast of the medium to longer term financial challenges which were likely to impact on the Integration Joint Boards future delegated budget and set out the framework within which these challenges would be mitigated to enable the Integration Joint Boards strategic priorities to be delivered within a balanced budget.

 

The Integration Joint Board agreed:-

(i) to note the potential financial challenges which may impact on the Integration Joint Boards delegated budget over the medium to longer term as set out in sections 4.1.1 to 4.1.8 and Appendix 1 of the report; and

 

(ii) to approve the framework and range of principles under which the Integration Joint Board would approach these challenges to ensure the Integration Joint Board was able to deliver its strategic and commissioning priorities whilst delivering a balanced budget as set out in section 4.1.9 of the report.

 

Following questions and answers the Integration Joint Board further agreed:-

 

(iii) that a further statement be added to section 4.1.9 of the report as follows:- "Promoting innovation that could improve care and support to our stakeholders and may encourage funding from Scottish government to deliver;

 

(iv) to note as indicated by the Chief Finance Officer that if there were any service redesign proposals arising from the strategic priorities these would be submitted to the Integration Joint Board;

 

(v) to note as indicated by the Chief Officer that every effort would be made to engage with service users at the earliest opportunity in the interests of early intervention; and

 

(vi) to note as indicated by Donald McPherson that Appendix 1 of the report served as a useful road map for the future partnership working arrangement.

VI MEETINGS OF THE INTEGRATION JOINT BOARD 2021 ATTENDANCES

There was submitted a copy of the Attendance Return DIJB11-2021 for meetings of the Integration Joint Board held to date over 2021.

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

VII DATE OF NEXT MEETING

 

The Integration Joint Board agreed to note that the next meeting of the Integration Joint Board would be held remotely on Wednesday, 21st April, 2021 at 10.00 am.

 

Following discussion the Integration Joint Board further agreed that the Clerk be remitted to submit a note to the next meeting of the Integration Joint Board on the recording of meetings of the Integration Joint Board in consultation with the Chair and Vice Chair.

 

 

 

 

KEN LYNN, Chairperson.