Publication
At a MEETING of the PERFORMANCE AND AUDIT COMMITTEE OF THE DUNDEE CITY HEALTH AND SOCIAL CARE INTEGRATION JOINT BOARD held remotely on 25th September, 2024.
Present:-
|
Members |
Role |
|
Ken LYNN (Chair) |
Nominated by Dundee City Council (Elected Member) |
|
David CHEAPE |
Nominated by Health Board (Non-Executive Member) |
|
Dorothy McHUGH |
Nominated by Dundee City Council (Elected Member) |
|
Dave BERRY |
Acting Chief Officer |
|
Barry HUDSON |
For Chief Internal Auditor |
|
Christine JONES |
Acting Chief Finance Officer |
|
Glyn LLOYD |
Chief Social Work Officer |
Non-members in attendance at the request of the Chief Finance Officer:-
|
Linda GRAHAM |
Health and Social Care Partnership |
|
Jenny HILL |
Health and Social Care Partnership |
|
Matthew KENDALL |
Health and Social Care Partnership |
|
Clare LEWIS-ROBERTSON |
Health and Social Care Partnership |
|
Lynne MORMAN |
Health and Social Care Partnership |
|
Kathryn SHARP |
Health and Social Care Partnership |
|
Angie SMITH |
Health and Social Care Partnership |
|
Lynsey WEBSTER |
Health and Social Care Partnership |
Ken LYNN, Chairperson, in the Chair.
I APOLOGIES FOR ABSENCE
There were apologies for absence submitted on behalf of Vicky Irons, Jocelyn Lyall, Sanjay Pillai and Martyn Sloan.
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 22nd May, 2024 was submitted and approved.
(b) ACTION TRACKER
There was submitted the Action Tracker, PAC29-2024, 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) to note that in relation to action no 1 (briefing notes) the Acting Chief Officer would speak to the Clerk to get the issue concluded before the next meeting;
(ii) to note that, in relation to a suggestion from David Cheape, consideration would be given to setting a target date for all actions to be completed; and
(iii) to note that Councillor McHugh would follow up out with the meeting with a query she had in relation to action no 5 (disparity in delayed discharge performance).
IV ANNUAL PERFORMANCE REPORT 2023/24
There was submitted Report No PAC24-2024 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 and approval by the Integration Joint Board on 21st August, 2024.
The Committee 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 versions 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 note that the Integration Joint Board approved the Annual Performance Report on 21st August, 2024 and instructed the Chief Officer to update the report with financial year 2023/2024 data for all National Health and Wellbeing indicators as soon as data was made available by Public Health Scotland (section 4.2.6 of the report).
Following questions and anwered the Committee further agreed:-
(iv) to note that an amendment was required in relation to the years stated on page 23;
(v) to note that, in relation to a query about staffing capacity, a report on the updated Workforce Plan would be submitted to the next Integration Joint Board meeting; and
(vi) to note that consideration would be given to the length of future agendas/reports in response to comments made by members.
V DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP PERFORMANCE REPORT 2023/2024 QUARTER 4
There was submitted Report No PAC27-2024 by the Chief Finance Officer providing an update on 2023/2024 Quarter 4 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 of the report);
(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 of the report); 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 of the report.
Following questions and answers the Committee further agreed:-
(v) to note that changes in some of the data was as a result of work undertaken with the Scottish Government to rationalise data recording and also the introduction of a test of change;
(vi) to note that the national indicator - % staff who say they would recommend their workplace as a good place to work was never followed through by the Scottish Government and consideration would be given to either removing this or creating a proxy indicator for each of the employers.
VI DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP CLINICAL, CARE AND PROFESSIONAL GOVERNANCE ASSURANCE REPORT
There was submitted Report No PAC32-2024 by the Clinical Director providing assurance to Committee on the business of Dundee Health and Social Care Partnership Clinical, Care and Professional Governance Group.
This aligned to the following NHS Scotland quality ambitions:
- Safe
- Effective
- Person-centred
The report provided evidence of the following Best Value Characteristics:
- Equality
- Vision and Leadership
- Effective Partnerships
- Governance and Accountability
- Use of Resources
- Performance Management
- Sustainability
The Committee agreed:-
(i) 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 this report is to 31st May 2024;
(ii) to note that the Lead Officer for Dundee HSCP, Dr David Shaw suggested that the level of assurance provided was:
Reasonable; due to the following factors:
- There was evidence of a sound system of governance throughout the HSCP.
- The identification of risk and subsequent management of risk was articulated well throughout services.
- There was ongoing scope for improvement across a range of services, in relation to the governance processes, although this was inextricably linked to the ongoing difficulties with recruitment and retention of staff.
- There was evidence of noncompliance relating to a fully comprehensive governance system across some teams, i.e. contemporary management of adverse events and risks.
Following questions and answers the Committee agreed to accord with the level of assurance as indicated above.
VII QUARTERLY FEEDBACK REPORT 1ST QUARTER 2024/2025
There was submitted Report No PAC31-2024 by the Chief Finance Officer summarising feedback received for the Health and Social Care Partnership (HSCP) in the first quarter of 2024/2025. The complaints included complaints handled using the Dundee Health and Social Care Partnership Social Work Complaint Handling Procedure, the NHS Complaint Procedure, and the Dundee City Integration Joint Board Complaint Handling Procedure. Complements received were also reported.
The Committee agreed:-
(i) to note the complaints handling performance for health and social work complaints set out within the report;
(ii) to note the work which had been undertaken to address outstanding complaints within the HSCP and to improve complaints handling, monitoring and reporting;
(iii) to note the recording of Planned Service Improvements following complaints that were upheld or partially upheld; and
(iv) to note the work ongoing to implement Care Opinion as a feedback tool for all services in the Health and Social Care Partnership.
VIII DUNDEE HEALTH AND SOCIAL CARE PARTNERSHIP STRATEGIC RISK REGISTER UPDATE
There was submitted Report No PAC33-2024 by the Chief Finance Officer providing an update 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; and
(ii) to note the extract from the Strategic Risk register attached at Appendix 1 to the report.
IX MENTAL HEALTH SERVICES INDICATORS - 2023/24 QUARTER 4
There was submitted Report No PAC26-2024 by the Chief Finance Officer reporting a suite of measurement relating to the activity of mental health services for scrutiny and assurance.
The Committee agreed:-
(i) to note the content of the report, including current performance against the suite of mental health service indicators (section 6 and appendix 1 of the report); and
(ii) to note the operational and strategic supporting narrative in the context of the trends in performance and activity (section 7 of the report).
Following questions and answers the Committee further agreed:-
(iii) to note that when referrals were rejected is usually indicated that the person was already in receipt of care and treatment;
(iv) to note that it was still not clear on what was driving demand but that work was taking place with Public Health at an early stage on modelling; and
(v) to consider if data could be gathered in relation to whether parents/carers, of children who were on the Child Protection register, were offered mental health support, if they engaged and what impact the support had.
X DRUG AND ALCOHOL SERVICES INDICATORS 2023/24 QUARTER 4
There was submitted Report No PAC23-2024 by the Chief Finance Officer providing an update 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 2023/2024 (section 6 and appendix 1 of the report); and
(ii) to note the range of ongoing improvement activity being progressed across drug and alcohol services (section 7 of the report).
Following questions and answers the Committee further agreed:-
(iii) to note that, in response to a query from Councillor McHugh, that Lynsey would check the data to establish whether the number of unplanned discharges where the service user disengaged increased by 38% related to drug and alcohol services; and
(iv) that consideration would be given to providing data on alcohol related deaths in future reports;
(v) to note that the redeuction in total spend on prescriptions generated by Dundee Drug and Alcohol Recovery Service (DDARS and Dundee Drug Treatment Service (DDT)) was due to a change in the pharmacy systems that provide the data as there was no longer rolling data available.
XI UNSCHEDULED CARE
There was submitted Report No PAC28-2024 by the Chief Finance Officer providing an update on Unscheduled Care Services and Discharge Management performance in Dundee.
The Committee agreed:-
(i) to note the current position in relation to complex and standard delays as outlined in sections 5-8 of the report; and
(ii) to note the improvement actions planned to respond to areas of pressure as outlined in section 9 of the report.
Following questions and answers the Committee further agreed:-
(iii) to note that information on average duration of delay had been included in the report and Lynne Morman would appreciate any feedback from members.
XII HEALTH AND CARE EXPERIENCE SURVEY 2023-24 ANALYSIS
There was submitted Report No PAC25-2024 by the Chief Finance Officer providing an update on the responses from the 2023/2024 Health and Care Experience Survey, which was used to provide measurement for National Health and Wellbeing Indicators 1 to 9.
The Committee agreed:-
(i) to note the content of the report, including the results of the 2023/2024 survey for Dundee Health and Social Care Partnership (appendix 1);
(ii) to note the longitudinal changes to performance over the last three biennial surveys (section 5 of the report); and
(iii) to note the performance of Dundee Health and Social Care Partnership against the Scottish average and eight Family Group Partnerships (section 6 of the report).
XIII CARE INSPECTORATE GRADINGS REGISTERED CARE HOMES FOR ADULTS/
There was submitted Report No PAC22-2024 by the Chief Finance Officer summarising the gradings awarded by the Care Inspectorate to Dundee registered care homes for adults/older people and other adult services in Dundee for the period 1st April, 2023 to 31st March, 2024.
The Committee agreed:-
(i) to note the scale and scope of Care Inspectorate led inspections carried out in 2023/2024 during the reporting year (section 4.1 of the report);
(ii) to note the contents of the report and the gradings awarded as detailed in the performance report (attached as Appendix 1 to the report) and highlighted in section 4.2 of the report; and
(iii) to note the range of continuous improvement activities progressed during 2023/2024 as described in section 4.3 and Appendix 1 of the report.
Following questions and answers the Committee further agreed:-
(iv) to note that an IJB briefing session on Social Care Commissioning had been arranged to take place on Tuesday 3rd December 2024 and a rep from the Care Inspectorate had been invited to present at the session.
XIV GOVERNANCE ACTION PLAN PROGRESS REPORT
There was submitted Report No PAC30-2024 by the Chief Finance Officer providing an update on the progress of the actions set out in the Governance Action Plan.
The Committee agreed:-
(i) to note the content of the report and the progress made in relation to the review of the Governance Action Plan; and
(ii) to instruct the Chief Finance Officer to provide a full report on the progress against all actions within the revised Governance Action Plan no later than 20th November, 2024.
XV DUNDEE INTEGRATION JOINT BOARD INTERNAL AUDIT PLAN PROGRESS REPORT
There was submitted Report No PAC34-2024 by the Chief Finance Officer providing an update on the 2023/2024 Internal Audit Plan and non-discretionary aspects of the 2024/2025 internal audit plan. 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 on the 2023/2024 internal audit plan and initial work on the 2024/2025 plan.
Following questions and answers the Committee further agreed:-
(i) to note that Internal Audit were looking at ways of making the summaries on partner organisations report more succinct.
XVI INTERNAL AUDIT PLAN 2024/25
There was submitted Report No PAC35-2024 by the Chief Finance Officer seeking approval of the 2024/2025 Annual Internal Audit Plan for Dundee City Integration Joint Board (IJB) and the revised and updated Internal Audit Charter, and to agree the appointment of the Chief Internal Auditor for the financial year.
The Committee agreed:-
(i) to the continuation of Fife, Tayside and Forth Valley Audit Internal Audit (FTF) as the IJBs lead internal auditors and therefore continuing the role of Chief Internal Auditor for 2024/2025;
(ii) to approve the 2024/2025 Annual Internal Audit Plan as set out in Appendix 1 of the report; and
(iii) to approve the revised and updated Internal Audit Charter set out in Appendix 2 of the report.
Following questions and answers the Committee further agreed:-
(iv) to note that Barry Hudson would provide Councillor McHugh with information on the changes made to the Internal Audit Charter.
XVII ATTENDANCE LIST
There was submitted Agenda Note PAC36-2024 providing attendance returns for meetings of the Performance and Audit Committee held over 2024.
The Committee agreed to note the position as outlined.
XVIII DATE OF NEXT MEETING
The Committee agreed to note that the next meeting of the Committee would take place remotely on Wednesday, 20th November, 2024 at 10.00am.
Ken LYNN, Chairperson.