Summary of Integration Joint Board meeting: September 2024

Falkirk’s Integration Joint Board, responsible for the strategic planning and operational oversight of local health and social care services, met on 27 September 2024. Here’s a summary of the discussion:

Chief Officer Report

Presented at each board meeting, the Chief Officer report provides an overview of local and national developments across health and social care. This provided members an update on:

• The appointment of Tom Cowan, Interim Head of Primary Care for the Partnership.
• An overview of the proposed new senior leadership structure for the Partnership.
• Progress of the Integration Programme Board, which is finalising proposals to integrate Children’s Social Work and Justice Services into the Partnership.
• A review of the Board’s Integration Scheme, with a draft scheme due for consultation soon
• Inspection results from local services, including Housing with Care and HMP YOI Stirling, which the Partnership hosts healthcare services for.
• The relaunch of the Dollar Park Dementia Service.
• News of the National Care Service’s progress to Stage 2 scrutiny within the Scottish Parliament.
• Relevant updates from the Scottish Government’s 2024/25 Programme for Government and Pre-Budget Fiscal Update.

Financial Updates & Budget Strategy

The Board received a high-level summary of the projected 2024/25 financial position, a summary of actions underway to address expected overspends, and an overview of the budgetary approach for the next financial year (2025/26). Key updates include:

• As experienced across the public sector, the Partnership is facing a very challenging financial position. Reflecting the high demand upon services, a projected overspend of £5.9m is expected on the integrated budget for this financial year (2024/25).
• Within Agenda Item 6, a budget recovery plan outlines savings measures to address this overspend. This includes a direction to all staff to prevent non-essential spending; increased scrutiny of agency spending; scrutiny of vacancy requests; review of the budget calculator used to allocate Self-Directed Support budgets; and d use of one-off reserve funds.
• The continued use of reserve funding to meet budget gap pressures is not sustainable across future years, therefore the IJB Budget Strategy sets out an approach to put the Partnership on to a sustainable footing.
• Over the next three years, a cumulative budget gap of £18.9m has been identified, consisting of a 2025/26 gap of £11.6m, and £7.1m over 2026/27 and 2027/28.
• To address this, a budget working group has been convened comprising of the Chief Officer, Chief Finance Officer, HR representatives, and members of the Senior Management Team. The group will bring forward a package of potential savings and transformation options for the next three years. A series of IJB Development Sessions will be held in October, December, and February, to discuss and review progress, with a period of public consultation beginning in January
• The IJB 2025/26 Budget and updated Medium Term Financial Plan will be presented for approval at the IJB’s March meeting. This follows the Scottish Government’s funding settlements expected early-December and the confirmation of indicative funding from Falkirk Council on 27 February and from NHS Forth Valley in March.

Interim Care Bed Proposal: Increasing system capacity

The Board has agreed to commission a block of 16 care beds within a local care home to support timely discharge from hospital. The beds have been identified within a unit of a care home which is currently not in use. Over the next 18 months, these beds will be used to support adults who are ready to leave hospital but require 24-hour residential or nursing support. This will increase capacity across the system, and ensure people return to a homely environment as soon as possible.

Following the finalisation of contractual arrangements and minor cosmetic works undertaken to bring the care home unit back into use, it is expected that first admission to the care beds could occur from early December 2024.

Garden Aid Policy

The Board has agreed to extend weed control support and introduce new eligibility criteria for Falkirk’s Garden Aid Service. The decision will relieve £217,000 from the budget for health and social care services. You can read more about this service change, which will take effect from 1 April 2025, on the Partnership’s news pages.

Locality Planning

As part of legalisation which established Scotland’s Integration Joint Boards, The Partnership is required by the Scottish Government to conduct locality planning. This paper sets out how the Partnership will develop new plans for its East, West and Central locality areas. These will help identify any distinct needs of our communities and outline how the Partnership’s strategic plan will be implemented in these areas.

The report proposed a staged approach to locality planning, starting with the Central Locality area. A Central Locality Delivery group has been established and will progress engagement, feedback opportunities and will draft a locality plan for presentation to the Board at its first meeting in 2025.

Locality delivery groups will be formed for East and West areas in December, with the aim of developing plans and submitting to the Board for approval in May 2025.

Medication Policy

An updated Medication Policy for Care and Support at Home Services has been approved by the Board. Last updated in November 2019, the new policy has been developed to reflect latest good practice and ensure consistency in its implementation.

The policy is used by Personal Carers who can help people to manage their medication. There are four Medication Support Levels (Independent, Prompt/Assist, Administration, and Health Care Professional Tasks Only). The policy outlines the tasks that may (and may not) be carried out by Personal Carer staff at each support level.

Staff training will be provided to introduce the new Medication Policy, ahead of its implementation from 1 March 2025. The policy will next be reviewed in September 2027.

Housing Contribution Statement

The Board has approved the refresh of the Partnership’s Housing Contribution Statement, which was last updated in December 2019. The Statement sets out the role of Housing within local health and social care services. This outlines out how services including garden aid, housing adaptations for disabled people, and support for people who are homeless are linked into health and social care.

The refreshed Housing Contribution Statement outlines 35 actions which will help to: increase the supply of affordable housing; allow people to take part in decisions about local housing support; prevent homelessness; promote independence for vulnerable people; address fuel poverty; improve the quality of local housing stock; and to work collaboratively with the private rented sector.

Some of these actions include:

• Deliver 5% of the Strategic Housing Investment Plan programme as wheelchair properties.
• Explore digital technology to assist owners improve property conditions.
• Develop and implement a housing specific domestic abuse policy.
• Work with partners and older people to create an easily understandable guide on housing for older people.
• Assist those in fuel poverty to access fuel vouchers and cost of living support from Home Energy Scotland and Falkirk Council.

Updates from Falkirk Alcohol and Drug Partnership

The Board regularly receives updates from Falkirk Alcohol and Drug Partnership (ADP). This report included a summary of the latest drug-related deaths data and the delivery of Medication Assisted Treatment (MAT) Standards. Key points include:

• The latest drug-related deaths data was published by National Records of Scotland in August 2024, with 1,172 drug related deaths recorded across Scotland in 2023. People living in the most deprived areas of Scotland were more than 15 times as likely to die from drug misuse than in the least deprived areas. Since 2000, the average age of drug deaths has increased from 32 years to 45 years in 2023. In 2023, Falkirk had 36 drug-related deaths in 2023. This is 13 (36%) more deaths than in 2022. Males accounted for 72% of Drug-related deaths in Falkirk in 2023, an increase of 50% of male deaths from the year before. The number of female deaths has stayed the same both years (10).
• The ADP is creating a new multiagency ‘Overdose Monitoring & Drug Death Review Group’ to review and plan the ADP’s response to drug related deaths and harm. The group is expected to be operational in time to report progress to the next ADP Executive in November 2024.
• The Public Health Scotland MAT Implementation Support Team published an update to their annual benchmarking report in June 2024. The report shows the expected milestones and achievements have been met across services, with Falkirk Alcohol and Drug Partnership rating ‘Green’ or ‘provisionally Green’ against all 10 MAT Standards.

Strategic Risk Register

The latest version of the Partnership’s Strategic Risk Register has been presented to the Board. The register is used to ensure the continued delivery of the Board’s strategic plan, and to identify, respond to, and manage risks and challenges.

The current risk register outlines 9 risks, covering finance, governance arrangements, partnerships, infrastructure, assurance, commissioning, system transformation, business continuity, and primary care. The monitoring of risks allows appropriate actions to be put in place to mitigate or alleviate pressures upon local services.

The strategic risk register is reviewed and updated by the Partnership’s Senior Leadership Team on a monthly basis, by the Audit Committee on a quarterly basis, and presented to the IJB biannually.

Recurring items

In addition to topical and thematic reports, the Board received recurring updates and governance statements covering:

• Agenda item 13: Partnership Funding Progress Report
• Agenda item 16: Performance Management Report
• Agenda item 17: Annual Assurance Statements 2023/24
• Agenda item 18: Communications & Engagement Update

Watch the discussion

Integration Joint Board meetings are livestreamed on Falkirk Council’s Committee Meetings YouTube channel. A recording is available to watch shortly after. A copy of all Board reports can be found on the Falkirk Council committee webpages.