Feedback notes Edinburgh H&SC Partnerships 11th March 2016
Deputation: reformed Patients Council raised issues re obesity and mental health. Noted issues referred to in strategic plan and priority work plan.
Minutes – agreed
Standards officer – agreed Gavin King
Financial regulations: 2.9 paper – where lack of clarity re legal authority to incur expenditure IJB chief finance officer will be consulted – IIB remains the decision making body.
Financial update: should have further information re offer from NHS Lothian within next couple of weeks. Edinburgh well represented in these discussions. NB Scottish Government will not agree HS budgets until May/June 2016. Real issue is how we can progress our agenda of radical change within such a limited budget. R Mc-G have to cut cloth but drive is that we are better working together and if we reduce pressure on acute services this will transfer to community supports. Financial plan will now be developed in detail from the information we currently have. Financial plan now has to have the detail which indicates how the priorities and ambitions of the strategic plan can be delivered.
Tripartite agreement: leadership group has been meeting for over year – IJB chief officer, CEO NHS Lothian and CEC. This group will now fold as purpose was to agree how IJB will be set up. This agreement is how we will work together going forward. This is not a decision making group but one that will help resolve issues. Concern raised re how proposed resolutions are reported and where decision making powers actually lie. Agreed that there is an amendment needed which says minutes are shared and on the IJB agenda as standing item. Experience of trying to shift resource makes this group vital.
Rolling action log: 2: visits composite list now established now need to nail down actual dates of visits, should have before the next formal meeting.
Strategic Plan: diagram on page 26 may be of particular interest as it shows how all sectors will work together. Welcome addition of housing statement. CEC receiving report on housing for people with additional needs being drafted – x ref to IJB vital. What about other Council Depts. input? Noted WHO – recommendation health should be integral to all policies and actions. Raised pivotal role of Localities in making priorities real and health becoming everyone’s business. Congratulations to Wendy on a very comprehensive strategic plan. Agreed.
Workforce planning: update on CEC and NHS plans but work is also happening with wider partners. More staff engagement events planned over next couple of months. Leadership programme “playing to your strengths” will continue until September 2016. Team development work being facilitated by Animate. Commitment in strategic plan is set up multidisciplinary workforce planning group (learning and development alliance) – first meeting later March 2016. EVOC and Scottish Care will lead on campaign to develop awareness of care as a career. Processes have to facilitate the cultural, role and responsibility changes required to provide truly integrated workforce. Recruitment and retention in face of current negative media will continue to be an issue. Union concern re blurring edge of professions – opposition to creating generic workers. Michele Miller – need to think differently – not about diluting specialist knowledge but about focusing on what are we trying to achieve and how can we do that, there may be completely new roles that we haven’t thought about yet. Excitement is about the opportunity to think differently. Note paper as good start but want it to pick up pace and drive this fundamental issue forward across all sectors.
Hub test of change: reminder it’s about moving away from a hospital bed based approach.Looking at referral mechanisms – GPs keep it simple, single point of contact preferred. Huddles now meeting. As there a number of initiatives happening concurrently it is difficult to attribute totality of shifts to test of change – work continuing on this evaluation. Third sector have to be integral to huddle and EVOC progressing this work. Need to have clarity re core objectives and from that the measures will flow.
Delayed discharge: report summarises current situation and actions. 50 people waiting on care at home, 28 waiting on care home. Note – need to find solution for people where legal issues are not being resolved e.g. guardianship, contractual issues cannot be hidden in the report so would prefer these are up front noted in report. Potential for 3rd sector to be involved as preventative/early planning with people and their families.
Development of Lothian hospitals plan: time constraint resulted in quick presentation net message is “retained” services are also developing clear strategic plan which not only drives capital building plans but also cements inter dependencies between IJB and acute services. (Realistic medicine, clinical strategy and population planning – links to be sent out with minutes). Need information re population predictions which will put into context. Agreed will be a development session.
Inclusive Edinburgh: work stream underway. Third sector welcome this report and would like to ensure there is continuing emphasis on prevention – particularly exclusion policies. Winter care shelters seeing dramatic increase in people presenting with acute mental health issues (note this is a service which is entirely funded through Bethany). Noted that this paper has been cited within CEC as not all services impacted are within remit of IJB. Noted this paper is result of a wide range of stakeholder engagement, agreed will go formally through professional advisors committee. Agreed recommendations.
H & SC population and premises: presentation. Population increase –analysis indicates that population increase will continue. 1 in3 GP practices restricted access. This is real risk for success of IJB. Particular issue for Edinburgh is land/premises costs. Planning – what is requirement on builders? Limited. Note CEC are major landowners in the city so we need to work closely. Not just land/premises but recruitment and retention is also important, design around integration has to be at the heart of this. Need evidence that there is correlation between this issue and NHS / CEC building disposal policy and practice. Central to strategic plan is the sustainability of primary care.
Verbal update:
Audit and risk Cttee: 6 members agreed. Paper drafted re work that needs to be done. Education/induction of Cttee being finalised. Meetings are now being scheduled.
Professional advisory group: meeting some administrative issues which are being worked on.
Performance sub group: remit now agreed following 2 x ½ day planning sessions. Remit and membership will be circulated to IJB. Membership is wide but this should ensure ownership across all stakeholders. Papers to be circulated.
Strategic planning group: work now completed! Remit being adjusted and will continue to meet. (see papers from strat grp)
Gamechanger – held over.