Publication

At a MEETING of the PERFORMANCE AND AUDIT COMMITTEE OF THE DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held remotely on 22nd November, 2023.

Present:-

Members	Role

Ken LYNN (Chairperson)	Nominated by Dundee City Council (Elected Member)
Dorothy McHUGH	Nominated by Dundee City Council (Elected Member)
Donald McPHERSON	Nominated by Health Board (Non Executive Member)
Sam RIDDELL	Nominated by Health Board (Non Executive Member)
Dave BERRY	Chief Finance Officer
Vicky IRONS	Chief Officer
Jocelyn LYALL	Chief Internal Auditor
Diane MCCULLOCH	Chief Social Work Officer

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

Jenny HILL	Health and Social Care Partnership
Brian HOWARTH	Audit Scotland
Christine JONES	Health and Social Care Partnership
Matthew KENDALL	Health and Social Care Partnership
Clare LEWIS-ROBERTSON	Health and Social Care Partnership
Mary OCONNOR	Audit Scotland
Kathryn SHARP	Health and Social Care Partnership

Ken LYNN, Chairperson, in the Chair.

I APOLOGIES FOR ABSENCE

There were apologies for absence submitted on behalf of:-
Dr James COTTON	Registered Practitioner not providing primary medical care services
Raymond MARSHALL	Staff Partnership Representative
Martyn SLOAN	Person providing unpaid care in the area of the local authority

II DECLARATION OF INTEREST

There were no declarations of interest.

lll MINUTE OF PREVIOUS MEETING AND ACTION TRACKER

(a) MINUTE

The minute of meeting of the Committee held on 27th September, 2023 was submitted and approved.

(b) ACTION TRACKER

There was submitted the Action Tracker, PAC47-2023, for meetings of the Performance and Audit Committee for noting and updating accordingly.

The Committee agreed to note the content of the Action Tracker.

Following questions and answers the Committee further agreed:-

(i) that as actions 1 and 2 related to staff capacity, the Chief Finance Officer would provide an overview of progress with the staffing restructure and the additional capacity that could be available; and

(ii) that a session would be arranged for all IJB members and the Care Inspectorate to focus on the grading process, an overview of gradings across the country and how Dundee compares and the Care Inspectorates powers. The session would also cover the internal processes that were used by the Health and Social Care Partnership.

lV AUDIT SCOTLAND ANNUAL REPORT AND INTEGRATION JOINT BOARD ANNUAL ACCOUNTS 2022/2023

There was submitted Report No PAC41-2023 by the Chief Finance Officer presenting the Integration Joint Boards (IJB) Draft Audited Annual Statement of Accounts for the year to 31st March 2023 for approval, to note the draft external auditors report in relation to these accounts and approve the response to the report.

The Committee agreed:-

(i) to note the contents of the attached Audit Scotland cover letter (attached as Appendix 1) and the draft external auditors report (attached as Appendix 2) including the completed action plan outlined on pages 20-21 of the report, and in particular that Audit Scotland have indicated they would issue an unqualified audit opinion on the IJBs 2022/23 Annual Accounts;

(ii) to endorse the report as the IJBs formal response to the external auditors report;

(iii) to instruct the Chief Finance Officer to provide an update on progress of the action plan noted in Appendix 1 of the external auditors report by February 2024;

(iv) to approve the attached Audited Annual Accounts (attached as Appendix 3) for signature and instruct the Chief Finance Officer to return these to the external auditor; and

(v) to instruct the Chief Finance Officer to arrange for the Annual Accounts to be published on the Dundee Health and Social Care Partnership website by no later than 30th November, 2023.

Following questions and answers the Committee further agreed:-

(vi) to note that although Internal Audit had found some weaknesses in Dundee City Councils General Ledger system (as outlined in Article X on this agenda), Audit Scotland had found no significant material issues in relation to the Integration Joint Board annual accounts. The Chief Finance Officer also explained that the majority of the spend went through the Mosaic and payroll systems which had good controls in place;

(vii) that the Chief Finance Officer would check with Dundee City Council reps when the General Ledger system issue would be resolved and report back to Donald McPherson; and

(viii) to note that the 2024/2025 position would be reported to the IJB meeting in December 2023 with IJB budget development sessions starting in December running through to March 2024.

V DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP PERFORMANCE REPORT 2023-2024 QUARTER 1

There was submitted Report No PAC42-2023 by the Chief Finance Officer updating the Performance and Audit Committee on 2023-2024 Quarter 1 performance against the National Health and Wellbeing Indicators and Measuring Performance Under Integration indicators. Data was also provided in relation to Social Care Demand for Care at Home services.

The Committee agreed:-

(i) to note the content of the summary report;

(ii) to note the performance of Dundee Health and Social Care Partnership, at both Dundee and Local Community Planning Partnership (LCPP) levels, against the National Health and Wellbeing Indicators as summarised in Appendix 1 (tables 1, 2 and 3);

(iii) to note the performance of Dundee Health and Social Care Partnership against the Measuring Performance Under Integration indicators as summarised in Appendix 1 (table 3) and

(iv) to note the number of people waiting for a social care assessment and care at home package and associated hours of care yet to be provided in Appendix 2.

Following questions and answers the Committee further agreed:-

(v) to note that the baseline year had been changed to 2018/2019 to be in line with what was required under the Public Bodies (Joint Working) (Scotland) Act 2014 and associated regulations and guidance and that this would be unlikely to move again until the Covid years were cleared; and

(vi) that, in relation to a query from Councillor McHugh about why there was disparity in delayed discharge performance across LCPPs, Kathryn would consider with Lynsey Webster if further analysis was required.

VI DRUG AND ALCOHOL SERVICES INDICATORS 2023/2024 QUARTER 1

There was submitted Report No PAC40-2023 by the Chief Finance Officer updating the Performance and Audit Committee on the performance of Drug and Alcohol Services.

The Committee agreed:-

(i) to note the data presented in the report, including the improvements in key indicators relating to access to drug treatment services during 2022/2023 (section 6 and Appendix 1); and

(ii) to note the range of ongoing improvement activity, including within Dundee Drug and Alcohol Recovery Service, Primary Care and Partnership Mental Health Services focused on implementation of Medication Assisted Treatment Standards and wider priorities agreed via the Alcohol and Drug Partnership Strategic Framework and Delivery Plan (section 7).

VII DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP CLINICAL, CARE AND PROFESSIONAL GOVERNANCE ASSURANCE REPORT

There was submitted Report No PAC45-2023 by the Clinical Director providing assurance to Committee on the business of Dundee Health and Social Care Partnership Clinical, Care and Professional Governance Group.

The report was brought to the Committee to provide assurance on the clinical and care governance activities and arrangements across the Partnership as outlined in the Getting It Right For Everyone (GIRFE) Framework in accordance with the Partnership integration scheme. Clinical Governance was a statutory requirement to report on, at Board level, from Scottish Government as per NHS MEL(1998)75. The Performance and Audit Committee was being asked to provide their view on the level of assurance the report provided and therefore, the level of assurance regards clinical and care governance within the Partnership. The timescale for the data within the report was to 30th September, 2023.

The Committee agreed:-

(i) to note the Exception Report for the Dundee Health and Social Care Partnership Clinical, Care and Professional Governance Group as detailed from Section 4 of the report; and

(ii) that the level of assurance was reasonable due to the factors as indicated.

Following questions and answers the Committee further agreed:-

(iii) to note the responses provided in relation to queries about Mutual Aid Requests, negative media recording, violence and aggression and verified and unverified events; and

(iv) that Matthew would check the risk level for the Primary Care sustainability risk and report back to Sam.

VIII QUARTERLY COMPLAINTS PERFORMANCE 2ND QUARTER 2023/2024

The Committee agreed:-
to note the complaints handling performance for health and social work complaints set out within the report;
(i) to note the work which had been undertaken to address outstanding complaints within the HSCP and to improve complaints handling, monitoring and reporting;

(ii) to note the work ongoing to scope using Care Opinion as a feedback tool for all services in the Health and Social Care Partnership; and

(iii) to note the changes to mandatory SPSO (Scottish Public Service Ombudsman) complaint reporting requirements and consider the recommendations for the content for future complaints and feedback reports in Section 10.

Following questions and answers the Committee further agreed:-
(iv) to note that there were options for people to feedback through Care Opinion other than just on-line.

IX DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP STRATEGIC RISK REGISTER UPDATE

There was submitted Report No PAC43-2023 by the Chief Finance Officer updating the Performance and Audit Committee in relation to the Strategic Risk Register and on strategic risk management activities in Dundee Health and Social Care Partnership.

The Committee agreed:-

(i) to note the content of the Strategic Risk Register Update report;

(ii) to note the extract from the Strategic Risk register attached at Appendix 1 to the report; and

(iii) to note the recent work and future work on Risk Appetite as set out in Section 7 of the report.

X DUNDEE INTEGRATION JOINT BOARD INTERNAL AUDIT PLAN PROGRESS REPORT

There was submitted Report No PAC48-2023 by the Chief Finance Officer providing the Performance and Audit Committee (PAC) with an update on progress against the last remaining outstanding review from the 2022/2023 internal audit plan as well as work relating to 2023/2024. The report also included internal audit reports that were commissioned by the partner Audit and Risk Committees, where the outputs were considered relevant for assurance purposes to Dundee IJB.

The Committee agreed to note the progress of the outstanding internal audit review and progress against the 2023/2024 internal audit plan.

XI GOVERNANCE ACTION PLAN UPDATE

It was reported that at the meeting of the Performance and Audit Committee held on 27th September, 2023 (Article XVII of the minute of meeting refers), the Committee was advised that work to develop revised reporting of outstanding Governance Actions previously reported through the Governance Action Plan was ongoing and that the revised process would be presented to the November PAC meeting. Unfortunately, due to the complex nature of this work and to ensure there was no duplication of actions, this was not yet in a completed stage to present to the Committee. Officers would continue to work with Internal Audit to ensure the revised reporting process was available for the first PAC meeting of 2024.

The Committee noted the position.

XII ATTENDANCE LIST

There was submitted Agenda Note PAC46-2023 providing attendance returns for meetings of the Performance and Audit Committee held over 2023.

The Committee agreed to note the position as outlined.

XIII DATE OF NEXT MEETING

The Committee agreed to note that the next meeting of the Committee would be arranged to take place remotely in January 2024.

Ken LYNN, Chairperson.