1. health and fitness

To be approved by Shadow Integration Board
Minutes of East Ayrshire Shadow Integration Board
3pm, Tuesday 24 February 2015
The Marriage Suite, Rothesay House, 1 Greenholm Road, Cumnock,
KA18 1LH
Present:
Councillor Douglas Reid, EA Council, Chair
Councillor Tom Cook, EA Council
Councillor Maureen McKay, EA Council
Mr Ian Welsh, Non-Executive, NHS A&A
Mr Alistair McKie, Non-Executive, NHS A&A
Mr Eddie Fraser, Director of Health and Social Care Partnership
Mr Eddie Docherty, Associate Nurse Director, NHS A&A
Mr Ian Smith, Public Partnership Forum Representative
Mr Gordon McKay, Staffside Representative, NHS A&A
Ms Caroline Scott, Council Voluntary Organisation (CVO)
In
Attendance:
Ms Margaret Phelps, Corporate Officer, East Ayrshire HSCP
Mrs Eunice Johnstone, Planning Manager, NHS A&A
Ms Marianne Hayward, AHP Representative
Dr Erik Sutherland, Senior Manager of Planning and Performance, East
Ayrshire HSCP
Ms Annemargaret Black, Head of Primary and Community Services, East
Ayrshire HSCP
Mr Jim Lyon, Senior Manager Children’s Services, East Ayrshire HSCP
Mrs Pamela Milliken, Head of Primary Care and Out of Hours Community
Response Services, East Ayrshire HSCP
Mr Alex McPhee, Senior Manager of Finance, East Ayrshire HSCP
Miss Rebecca Hannah, Committee Secretary (Minutes)
1. WELCOME AND INTRODUCTIONS
1.1 Cllr Reid welcomed everyone to the meeting.
Action
2. APOLOGIES FOR ABSENCE
2.1 Apologies for the meeting were received from Iain Linton, Alison
Graham, Derek Lindsay, Liz Wilson, Catherine Bingham, Susan Taylor,
Shiona Johnston and Ruth Coughlan.
3. MINUTES OF PREVIOUS MEETING HELD ON 22 JANUARY 2015
3.1 The Board approved the minutes of the previous meeting held on 22
January 2015.
4. MATTERS ARISING
4.1 All matters arising had been completed before the meeting.
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To be approved by Shadow Integration Board
5. EAST AYRSHIRE AHPS SUPPORT IN HSCP
5.1 Ms Hayward gave a presentation to members on Allied Health
Professionals (AHP’s) activity within the Health and Social Care
Partnership. The following was discussed:
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Background of AHP’s
AHP Business unit
AHP Profile
Where in East Ayrshire AHP’s provide support bases
National and Local Delivery Plans
Key References
AHP Event
Next Steps
5.2 Cllr McKay queried how self referral routes can be utilised more
effectively. Ms Hayward advised there are several ways self referrals
can be more accessible to patients. There are discussions to have a
single point of contact, multi-disciplinary team drop in sessions across
different venues and accessing areas outside GP Practices. It is
expected that this could reduce GP time referring patients and reduce
A&E attendances.
5.3 Cllr McKay asked Mr Fraser if the HSCP achieves the decrease in A&E
attendances how this will be tracked. Mr Fraser explained that these
figures are already monitored. Ms Black informed members there is a
team working in A&E who determines if patients require A&E care or if
they can be seen in the community. The evaluation of this A&E team is
available for information.
5.4 Members discussed how services which are led by another Partnership
would report to the Partnership’s they are not led by. Ms Hayward
agreed to liaise with Ms Black to discuss AHP performance reporting.
MH/AMB
5.5 The Board agreed the recommendations to:
(i) recognise the contribution that AHPs can offer the HSCP.; and
(ii) to support these AHPs develop an action plan in line with the
East HSCP strategic plan. This will include mapping work already
achieved through the National Delivery Plan/ Local Delivery Plan.
6. STRATEGIC PLAN CONSULTATION
6.1 Mr Fraser gave an update to members. The following comments were
noted:
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There have been many meetings with groups to engage and offer
comments on the Strategic Plan.
Feedback has highlighted the need to review the wording within
the Strategic Plan and how this can be more engaging.
Online consultation closed on Monday 23 February, comments
are now being collated, making any changes and will be brought
to the next meeting on 26 March 2015.
It is expected that the full Strategic Plan, Delivery Plan and two
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To be approved by Shadow Integration Board
Public Health Needs Assessments will be tabled at the meeting in
March to be endorsed by members, ready for approval at the first
Integrated Joint Board meeting on 2 April 2015.
6.2 Mrs Johnstone advised the Integration Scheme was submitted on 2
February, the Scottish Government (SG) requested further information
which, was completed and submitted again on 20 February 2015.
7. FINANCE
7.1 Mr McPhee updated members on the financial outturn for the East
Ayrshire HSCP for 2014/15, based on the current financial position as at
31 December 2014. The following was noted:
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The East Ayrshire HSCP is currently overspent by £1.217m,
which consists of an adverse variance of £0.414m for services
managed within EAC and £0.803m for service managed within
NHS A&A respectively.
For services managed within East Ayrshire Council, the projected
variance predominantly relates to additional costs of adult care
packages, slippage in anticipated savings in adult day care
services, additional childcare placement costs (including secure
accommodation, foster care and adoption costs) and additional
externally commissioned care at home services.
The major component of the projected adverse variance on
services managed within NHS Ayrshire and Arran relates to a
projected overspend in Primary Care prescribing totalling
£0.704m which results from the cost per item prescribed being
higher than the original estimate.
In setting the budget, actions to generate recurring efficiency
savings of £2.365m have been agreed by East Ayrshire Council
for 2014/15.
It has been agreed that the Primary Care prescribing overspend
will be managed as a whole by NHS Ayrshire and Arran. The
budget for prescribing in Primary Care is established from first
principals each financial year.
7.2 Members queried the management of the Prescribing budget in Primary
Care. It was agreed to invite the Director of Pharmacy to a future
meeting to engage in discussions.
7.3 Cllr McKay requested additional information regarding the Prescribing
budget, in particular, a breakdown of costings.
RH
AMcP
7.4 Members raised concern with the absence of Lead Partnership budgets
such as Mental Health which is managed within the North Ayrshire
HSCP. Members felt it was important to have a view of Lead Partnership
projected costs in-year for budgetary control and monitoring purposes as
although, East Ayrshire HSCP is not the Lead Partnership for this
service mental health is strongly related to other services which are
managed by East Ayrshire HSCP such as Prescribing. Mrs Johnstone
advised that each Strategic Plan must consider the wider Partnerships,
ensuring there is no conflict or contradictions between one another. Mr
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To be approved by Shadow Integration Board
McPhee advised that a draft paper relating to the Mental Health Lead
Partnership has been discussed at the pan-Ayrshire Financial
Governance and Financial Planning workgroup. This paper highlighted
that agreement needs to be reached on contributions from individual
HSCPs where overspends occur.
7.5 Members noted that although services may be Lead by another
partnership the responsibility still lie within the Partnership area.
7.6 Cllr McKay noted the importance of the diversity of housing needs in
East Ayrshire and matching this with the complexity in health needs from
patients. Mr Fraser noted the importance of managing the expectations
of service users while providing the best care. It is expected the number
of people with multi-morbidity diseases will increase. Anticipatory care
packages are being developed to ensure patients leaving hospitals can
plan support packages ready for their return home.
7.7 Clarity was given to members that mental health adolescents are
managed under Children and Adolescent Mental Health Service
(CAMHS).
7.8 The Board agreed the recommendations to:
(i) note content of this report, including specific key actions on
significant variances.
8. BOARD DEVELOPMENT PROGRAMME
8.1 Mr Fraser advised members of a proposed development programme for
Board members. The following comments were made:
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Three development sessions will be arranged throughout the year
to provide continual development for members.
Sessions should last around two or three hours.
8.2 Cllr Cook requested dates be organised as soon as possible to ensure
members can attend.
RH
The Board agreed the recommendations to:
(i) Receive the report;
(ii) Approve the proposed schedule and content of the programme,
and;
(iii) Otherwise note and comment on the contents of this report.
9. PROPOSAL FOR WEBPAGE
9.1 Ms Phelps updated members on the progress in establishing a
webpage for the HSCP. The following comments were noted:
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The SIB meeting on 26 March 2014 approved a Communication
Plan to support the Integration of Health and Social Care. This
plan was split into four phases; progress of this plan is now
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To be approved by Shadow Integration Board
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completing stage three.
It was felt it would be beneficial to have a single point of contact
in the form of a webpage to provide information on the Integrated
Joint Board.
The webpage is expected to develop into a fuller website with
member’s details, links into plans and policies for public
information.
A learning academy is to be developed for staff use, giving
information including video links to meetings.
9.2 The Board agreed the recommendations to:
(i) Approve the proposal for the creation of a Health and Social Care
webpage; and
(ii) Note the contents of this report.
10. MANAGEMENT STRUCTURE
10.1 Mr Fraser requested endorsement of Board members to implement
management structures and support arrangements specifically relating to:
(i) Delivery of Community Health and Care Services;
(ii) Delivery of Children’s Health Care and Justice Services and;
(iii) Delivery of Primary Care and Out of Hours Community Response
Services.
The following comments were noted:
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There will be three Heads of Service who, will report to the Director
of Health and Social Care Partnership.
Nine new post will be established to support the delivery of
Community Health and Care Services. These are to be
redesigned from the existing management resource so will have
no financial impact.
An eighteen month post has been created to assist in developing
staff; this responsibility will belong to the Head of Service when the
post has reached eighteen months.
10.2 Cllr McKay noted the absence of Muirkirk in the Health and Care Services
Management Team. Ms Black agreed this should be included.
10.3 Mr McKay raised serious concern that NHS trade unions had not been
informed or involved in any management structure changes and, noted he
would not endorse the report as NHS A&A staffside representative. Ms
Black advised a meeting held between Heads of Service Groups had
included the Employee Director.
10.4 Mr Fraser advised the Board is facilitating ongoing changes within the
organisation while being supportive; it was felt that staff affected should be
made aware of any changes as soon as possible.
10.5 Mr Fraser gave commitment to meet with anyone uncertain of changes to
management structure for reassurance.
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To be approved by Shadow Integration Board
10.6 The Board, with the exception of Mr McKay, agreed the recommendations ,
to:
(i) Endorse the Management Structures as outlined in appendices,
2,3 and 4;
(ii) Note that further formal engagement with employee
representatives of both the NHS and the Council will now take
place in relation to the implementation of these proposals;
(iii) Agree funding from Integrated Care Fund for fixed term 18 month
Programme Manager post to support the development and
delivery of services priorities and increase operational planning
capacity to support the new team; and
(iv) Otherwise note the content of the report.
11. ANY OTHER BUSINESS
11.1 Looked After Children Incident – Mr Fraser advised members of an
incident involving a looked after child who is accommodated in Paisley.
The incident has resulted in the young man being cared for in Glasgow
Southern General Hospital. A full review will be undertaken which will
include Police Scotland, the service provider and the Care Inspectorate.
12. DATE OF NEXT MEETING –
3PM, THURSDAY 26 MARCH 2015, ROBERT BURNS SUITE, BURNS
MONUMENT CENTRE, KILMARNOCK
Chair ……………………………………………….
Date ………………………………………
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