Publication

At a MEETING of the DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held remotely on 21st August, 2024.

Present:-

Members	Role
Bob BENSON (Chairperson)	Nominated by Health Board (Non-Executive Member)
Ken LYNN (Vice Chair)	Nominated by Dundee City Council (Elected Member)
Siobhan TOLLAND	Nominated by Dundee City Council (Elected Member)
Dorothy MCHUGH	Nominated by Dundee City Council (Elected Member)
David CHEAPE	Nominated by Health Board (Non-Executive Member)
Beth HAMILTON	Nominated by Health Board (Non-Executive Member)
Dave BERRY	Acting Chief Officer
Suzie BROWN	Registered Nurse
Christina COOPER	Third Sector Representative
Dr Emma FLETCHER	Director of Public Health
Liz GOSS	Service User residing in the area
Christine JONES	Acting Chief Finance Officer
Jim McFARLANE	Trade Union Representative
Raymmond MARSHALL	Staff Partnership Representative
Dr David SHAW	Clinical Director
Dr David WILSON	NHS Tayside (Registered Medical Practitioner (whose name is included in the list of primary medical performers)

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

Joyce BARCLAY	Health and Social Care Partnership
James COTTON	NHS Tayside
Linda GRAHAM	Health and Social Care Partnership
Chris HEBENTON	Health and Social Care Partnership
Jenny HILL	Health and Social Care Partnership
Vered HOPKINS	Health and Social Care Partnership
Shona HYMAN	Health and Social Care partnership
Clare LEWIS-ROBERTSON	Health and Social Care Partnership
Julia MARTINEAU	Health and Social Care partnership
Sandra McLEOD	NHS Tayside
Claire PEARCE	NHS Tayside
Angie SMITH	Health and Social Care Partnership
Elaine WATSON	NHS Tayside
Lynsey WEBSTER	Health and Social Care Partnership

Bob BENSON, Chairperson, in the Chair.

I APOLOGIES FOR ABSENCE

Apologies for absence were submitted on behalf of:-

Member	Role
Vicky Irons	Chief Officer
Glyn Lloyd	Chief Social Work Officer
Dr Sanjay Pillai	Registered Medical Practitioner (not providing primary medical services)
Martyn Sloan	Person providing unpaid care in the area of the local authority

II DECLARATION OF INTEREST

There were no declarations of interest.

III MINUTE OF PREVIOUS MEETING

(a) The minute of meeting of the Integration Joint Board held on 19th June, 2024 was submitted and approved.

(b) ACTION TRACKER

The Action Tracker DIJB44-2024 for meetings of the Integration Joint Board was submitted and noted.

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

(i) that in relation to the action about nominations for the Falls Group, an earlier timescale would be sought for identifying reps.

IV FINANCIAL MONITORING POSITION AS AT JUNE 2024

There was submitted Report No DIJB41-2024 by the Chief Finance Officer providing an update of the projected financial position for delegated health and social care services for 2024/2025.

The Integration Joint Board agreed:-

(i) to note the content of the report including the projected operational financial position for delegated services for the 2024/2025 financial year end as at 30th June 2024 as outlined in Appendices 1, 2, and 3 of the report;

(ii) to note the actions being taken by Officers and Senior Management to address the current projected financial overspend position, with a report on progress and implications to develop a formal Financial Recovery plan to be presented at next IJB meeting (as detailed in section 4.5 of the report); and

(iii) to instruct the Chief Finance Officer to request a copy of the financial Recovery Plan for Tayside GP Out of Hours service from Angus IJB (as detailed in section 4.5.4 of the report).

V 5 YEAR FINANCIAL OUTLOOK 2024/25-2028/29

There was submitted Report No DIJB32-2024 by the Chief Finance Officer providing a forecast of the medium to longer term financial challenges which were likely to impact on the IJBs future delegated budget and setting out the framework within which these challenges would be mitigated to enable the IJBs 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 IJBs delegated budget over the medium to longer term as set out in sections 4.1.1 to 4.1.9 and Appendix 1 of the report; and

(ii) to approve the framework and range of principles under which the IJB would approach these challenges to ensure the IJB was able to deliver its strategic and commissioning priorities while delivering a balanced budget as set out in sections 4.1.10 and 4.1.11 of the report.

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

(iii) to note that the Chair would welcome a future Development Session on this subject.

VI DUNDEE IJB RESERVES INVESTMENT STRATEGY

There was submitted Report No DIJB45-2024 by the Chief Finance Officer providing an update to the Reserves Investment Strategy for Dundee Integration Joint Board to ensure the IJB was in a position to utilise all available resources it had to maximum effect to support the delivery of the strategic priorities set out within the Strategic and Commissioning Plan.

The Integration Joint Board agreed:-

(i) to note the update regarding the IJB Reserves Investment Strategy as set out in the report; and

(ii) to approve the proposed realignment of £2m from General Reserves to Transformation Funding Reserve, as set out in section 4.1.8 of the report.

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

(iii) to note the importance of being able to invest in transformation as highlighted by the Chief Officer.

VII TRANSFORMATION FUNDING FOR COMMUNITY FACING PALLIATIVE CARE SERVICES

There was submitted Report No DIJB47-2024 by the Chief Officer outlining proposed developments in the Specialist Palliative Care Service and to seek transformational funding to further explore and create collaborations with all care providers, statutory and otherwise, to strengthen community facing care to support the patients and their families, safely and effectively in their own homes.

The Integration Joint Board agreed:-

(i) to note the transformational nature of the proposed developments outlined in the report and the contribution to the strategic aims of continuous improvement of community facing palliative care services;

(ii) to approve the release of £115,083 of funding from transformation reserves to support the proposal outlined in Section 3.1 of the report;

(iii) to instruct the Chief Officer to provide a progress report prior to the end of the 18 month period to the IJB; and

(iv) to instruct the Chief Officer to issue the direction as attached at Section 8 of the report to NHS Tayside.

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

(v) to note that officers would explore making linkages across Tayside for joint learning etc.

VIII PSYCHOLOGICAL THERAPY SERVICES - ADHD

There was submitted Report No DIJB48-2024 by the Chief Officer providing a forecast of the medium to longer term financial challenges which were likely to impact on the IJBs future delegated budget and set out the framework within which these challenges would be mitigated to enable the IJBs strategic priorities to be delivered within a balanced budget.

The Integration Joint Board agreed:-

(i) to note the contents of the report;

(ii) to note the transformational nature of this proposal and its contribution to the strategic aims of the Neurodevelopmental Disorder Workstream within the Tayside Whole System Change Programme;

(iii) to approve the release of funding from ring fenced IJB Transformation Reserves to the value of £508,204 (as detailed in Section 4.16 of the report); and

(iv) to instruct the Chief Officer to note the direction as attached at Section 8 of the report.

IX REDESIGN OF MACKINNON CENTRE SERVICES

There was submitted Report No DIJB24-2024 by the Chief Officer seeking approval from the Integration Joint Board to revise the model of care provided at the MacKinnon Centre in order to respond to changing demands for services and increased complexity of needs.

The Integration Joint Board agreed:-

(i) to note the alteration of the use of 10 Respite Beds at the Mackinnon Centre to deliver a flexible combination of Respite Care beds and Longer-Term Step-Down beds for those in complex situations;

(ii) to cease providing a Skills Service at Mackinnon Centre to reflect low demand levels and alternative available supports; and

(iii) to instruct the Chief Officer to issue the direction as set out in Section 8 of the report.

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

(iv) to note that available accommodation would be used as a hub for clinics and pharamacy services for the local community.

X REDUCING HARM FROM DRUG AND ALCOHOL USE

There was submitted Report No DIJB39-2024 by the Independent Chair, Dundee Drug and Alcohol Partnership providing a summary overview of progress made during the first year of the Dundee Alcohol and Drug Partnerships Strategic Framework 2023/2028, and informing of priorities for the second year of delivery. It also sought approval of the annual return from the Dundee Alcohol and Drug Partnership to the Scottish Government.

The Integration Joint Board agreed:-

(i) to note the content of the report and the progress toward implementation of the Dundee Alcohol and Drug Partnerships (ADP) delivery plan (section 4.2 of the report);

(ii) to note the priority areas for year two of delivery (2024/2025) identified by the ADP and approved by the Chief Officers Group (section 4.3 of the report);

(iii) to note that the ADPs Annual Report to the Scottish Government had already been approved by the group and submitted as a draft to the Scottish Government on the 28 June 2024, to meet the Scottish Government submission date guidelines (section 4.4 of the report); and

(iv) to approve the draft ADP Annual Report (section 4.4 and appendix 1 of the report).

XI DELIVERY OF PRIMARY CARE IMPROVEMENT PLAN

There was submitted Report No DIJB43-2024 by the Chief Officer providing an update on the implementation of the Dundee Primary Care Improvement Plan for 2023/2024 and sought approval for the continued implementation of the Dundee Primary Care Improvement Plan for 2024/2025.

The Integration Joint Board agreed:-

(i) to note the progress in implementing the Dundee Primary Care Improvement Plan (PCIP) 2023/2024 (attached as Appendix 1 to the report) and the key achievements as described in Section 4 of the report;

(ii) to approve the proposed actions for Dundee Health & Social Care Partnership for 2024/2025 as described in Appendix 1 and to note the proposed allocation of funding as detailed in Section 3 of the report;

(iii) to note that aspects of the Plan which had been directed by the Scottish Government to be fully implemented continued to have ongoing gaps, for a range of reasons outlined;

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

(v) to note the previous agreement to delegate the monitoring of the Dundee allocation of the Primary Care Improvement Fund to the Dundee Primary Care Improvement Group as noted in Section 3.7 of the report; and

(vi) to instruct the Chief Officer to provide a further report on progress made against delivering the Dundee Primary Care Improvement Plan 2024/2025 to a future IJB.

XII DUNDEE INTEGRATION JOINT BOARD GENERAL PRACTICE STRATEGY UPDATE

There was submitted Report No DIJB40-2024 by the Chief Officer providing an update on the General Practice Strategy which was approved by the IJB on the 13th of December 2023. The Chief Officer was asked to give 6-monthly updates.

The Integration Joint Board agreed:-

(i) to note the progress to date made in implementing the General Practice (GP) Strategy; and

(ii) to instruct the Chief Officer to continue to update the IJB on 6-monthly basis.

XIII PROGRESS REPORT ON MENTAL HEALTH AND LEARNING DISABILITIES WHOLE SYSTEM CHANGE PROGRAMME

There was submitted Report No DIJB51-2024 by the Chief Officer providing a progress update in relation to the Mental Health and Learning Disability Whole System Change Programme.

The Integration Joint Board agreed:-

(i) to note the content of the update report on the Mental Health and Learning Disability Whole System Change Programme;

(ii) to note that the Chief Officer would continue to work with the NHS Tayside Executive Lead for Mental Health Services and the other Tayside IJB Chief Officers to ensure there was whole system leadership and continued delivery of the change programme at pace;

(iii) to note that work would continue to deliver a financial framework to support the delivery of the Model of Care and to shift the balance of care from inpatient services to community based services; and

(iv) to instruct the Chief Officer to develop a commissioning framework for mental health services by March 2025 to enable the IJB to commission an appropriate level of inpatient services for the local population from 2025/2026.

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

(v) to note the Staff Side and Trade Union commitment to supporting service change as highlighted by Raymond Marshall; and

(vi) that the Chief Officer would give consideration to Councillor McHughs comments in relation to the term model of excellence and whether alternative wording could be used in future.

XIV TAYSIDE INPATIENT LEARNING DISABILITY SERVICE

There was submitted Report No DIJB50-2024 by the Chief Officer advising of the operational decision taken by NHS Taysides Executive Leadership Team to progress the move to a single site for Tayside Inpatient Learning Disability Services in line with the strategic direction previously agreed by the Tayside Integration Joint Boards.

The Integration Joint Board agreed:-

(i) to note the content of the report on the Tayside Inpatient Learning Disability Service as attached as Appendix 1 to the report;

(ii) to note and support the request to reaffirm the strategic direction agreed in 2018 with regards to a move to a single site model for Tayside Inpatient Learning Disability Services;

(iii) to note the development of a comprehensive programme of work to progress the move to a single site by August 2025; and

(iv) to note the intention to provide quarterly progress reports to the IJB and to instruct the Chief Officer to ensure these are provided accordingly.

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

(v) to note the statement by all Trade Unions and Professional Organisations on behalf of Staff regarding move of LDAU Strathmartine to Murray Royal presented by Raymond Marshall asking that the IJB look at other options which all groups could sign up for; and

(vi) to note that Councillor McHugh had intimated her dissent from the foregoing decision at (ii) above to support and reaffirm the strategic direction agreed in 2018.

XV DUNDEE INTEGRATION JOINT BOARD EQUALITY OUTCOMES

There was submitted Report No DIJB46-2024 by the Chief Officer informing of progress towards achieving Dundee Integration Joint Board Equality Outcomes.

The Integration Joint Board agreed:-

(i) to note the progress that had been made during 2023/2024 to understand the health and social care needs, preferences and experiences of Transgender and Non-binary people and to learn more about the experiences of race discrimination across the health and social care workforce (sections 5.1 to 5.4 and 6.1 to 6.4 of the report);

(ii) to note the opportunities for action that had been identified to further progress these areas of work during 2024/2025, including the need for active participation and support from leaders across the health and social care sectors, such as IJB members (sections 5.5 to 5.6 and 6.5 to 6.6 of the report); and

(iii) to instruct the Chief Officer to submit a full update against all of the IJBs Equality Outcomes via the statutory Equality Outcomes and Mainstreaming Update and Progress Report 2023/2025, no later than the end of April 2025.

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

(iv) to note that although the IJB did not directly employ staff (other than the Chief Officer and Chief Finance Officer) there were a number of fora/settings where equalities issues could be discussed.

XVI ANNUAL PERFORMANCE REPORT 2023/2024

There was submitted Report No DIJB42-2024 by the Chief Officer submitting the three editions of the Dundee Integration Joint Board Annual Performance Report 2023/2024 for noting following their publication on 26th July, 2024.

The Integration Joint Board agreed:-

(i) to note the content of the report and of the three editions of the Annual Performance Report 2023/2024, available via the hyperlinks in section 4.2.2 of the report and with printable version contained within appendices 1 to 3 of the report;

(ii) to note that the Annual Performance Report 2023/2024 was published on 26th July, 2024 following approval by the Chair and Vice-Chair of the Integration Joint Board, the Clerk and the Partnerships Senior Management Team (section 4.2.1 of the report); and

(iii) to instruct the Chief Officer to update the Annual Performance Report with financial year 2023/2024 data for all National Health and Wellbeing indicators as soon as data is made available by Public Health Scotland (section 4.2.6 of the report).

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

(iv) that the report would be placed on the next Performance and Audit Committee agenda to allow further discussion, if required.

XVII MEETINGS OF THE INTEGRATION JOINT BOARD 2024

There was submitted a copy of the Attendance Return DIJB49-2024 for meetings of the Integration Joint Board held to date over 2024.

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

XVIII IJB DEVELOPMENT SESSIONS

The IJB noted that the following Development Sessions had been arranged:

18th September, 2024 Strategic Planning Committee Room 1, 14 City Square

30th October, 2024 Understanding Data venue TBC

13th November, 2024 Primary Care Committee Room 1, 14 City Square

3rd December, 2024 Social Care Commissioning venue TBC

18th December, 2024 Budget venue TBC

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, 23rd October, 2024 at 10.00am.

Bob BENSON, Chairperson.