To receive any apologies for absence.

Apologies for absence were received from:

-       Councillor Ali (Chair). Councillor Emsley attended the meeting as a substitute for Councillor Ali and kindly agreed to chair the meeting;

-       Councillor R. Massey. Councillor Smith attended the meeting as a substitute for Councillor Massey;

-       Steve Rumbelow. Jonathan Evans was in attendance as a substitute member for the Place Based Lead;

-       Nichola Thomson – Martin Lawton was in attendance as a substitute for the Deputy Place Lead;

-       Warren Heppolette; Paul Lynch was in attendance as a substitute for the NHS Greater Manchester Integrated Care Representative;

-       Sharon Hubber;

-       Alison Kelly; Susan Calvert attended the meeting and presented the report.

Members are required to declare any disclosable pecuniary, personal or personal and prejudicial interests they may have and the nature of those interests relating to items on this agenda and/or indicate if S106 of the Local Government Finance Act 1992 applies to them.  

There were no declarations of interest received.

To determine whether there are any additional items of business which, by reason of special circumstances, the Chair decides should be considered at the meeting as a matter of urgency.

There were no items of urgent business received.

To determine any items on the agenda, if any, where the public are to be excluded from the meeting.

There were no items for exclusion of press and public.

Members are requested to approve the Minutes of the Meeting held on 25^th April 2023

Resolved that the minutes of the meeting held on 25^th April 2023 be approved as a correct record.

To consider public questions received since last meeting of the Board

The Chair informed the Joint Committee that one question had been received in relation to Delivering a Net Zero Health Service. The response was being finalised and would be shared with the requestor and Board Members. 

Additional questions had been received from the same questioner, and, in line with the Public Questions Protocol, these would be presented at future Locality Board meetings, which would cover up to and including January 2024.

One question relating to Dentistry had been forwarded to HMR Primary Care Commissioning Committee (PCCC) and a response had been provided and shared with PCCC members. 

Resolved that the information be noted.   

To consider a report of the Locality Director of Strategic Performance – Health & Social Care – Item for decision

The Joint Committee received a report of the Locality Director of Strategic Performance – Health and Social Care which outlined the closing budget of Rochdale Locality element of the Greater Manchester Integrated Care Board (GM ICB) for the 12 months to 31^st March 2023 and Opening budgets for 12 months to 31^st March 2024.

The report author presented the information and pointed out that in relation to the unaudited closing position as of 31^st March 2023 (Month 12), the locality met the agreed position with NHS GM of £950k underspend due to non-recurrent mitigations.

The senior officer continued informing of the breakdown of the total budget of £112M for the HMR Locality as per table 2.7 of the report.

Resolved that the Closing budgets of Rochdale Locality element of the Greater Manchester Integrated Care Board (GM ICB) for the 12 months to 31st March 2023 and Opening budgets for 12 months to 31st of March 2024 be approved.

Reason: Overall, the budgets for 2023/24 had been uplifted in line with the national guidance with a further uplift for Prescribing and CHC being included at a GM level. The QIPP target has been applied to achieve a breakdown position.

Alternative considered and rejected: There were no alternatives to consider. Producing an end of year and an opening budget is a statutory requirement for the NHS GM IC HMR.

GM Update

The Joint Committee also noted the update provided by the Director of Strategy and Planning, NGH GM Integrated Care:

-       The NHS GM Joint Forward Plan was being developed and it would be shared imminently with all localities for their comments and feedback. The Joint Forward Plan would be the delivery plan for the GM Integrated Care Partnership Strategy and it sets objectives and priorities for all ten localities, the actions to deliver them, measures to track delivery and where accountability was held. The document was supported by a performance framework and ways of working. NHS England asked for the plan to be published by 30^th June 2023;

-       Primary Care Blueprint – this plan would be the next step for the NHS GM IC and it would include neighbourhood working, access to Primary Care and support to the workforce;

-       NHS Greater Manchester organisation structure and consultation closing on 31^st May 2023.

Resolved that the GM update be noted.

To consider a report of the Locality Director of Strategic Performance – Health & Social Care – Item for information

The Joint Committee received a report of the Locality Director of Strategic Performance Health and Social Care which updated on the financial position of the pooled budget for the financial year 2022/23. The pooled budget excluded the Better Care Fund which would be reported in a separate report at item 8b of today’s agenda.

Board Members were asked to note that, due to the current health funding arrangements, it had was agreed that the risk share agreement for 2022/23 would remain the same as in the previous two years, so both partners were responsible for their own pooled fund gap and in year underspend and overspend.

An overspend of £3.8m was being reported against the Local Authority’s pooled budgets (excluding Covid related pressures). This included pressures of £3.3m against Children’s budgets due to increased placement costs and Special Educational Needs Transport pressures, a net £0.7m pressures on Adult Social Care budgets due to increased placement costs offset by in-year savings on staffing costs due to vacancies, and a £0.2m in year saving forecast against Public Health budgets due to in year savings on staffing costs due to vacancies. This overspend would be funded by increased Local Authority’s contributions.

Covid pressures of £3.1m had been identified across Health and Social Care Pool in relation to Children’s (the full £3.1m) this would be wholly funded from Government emergency funding received by the Local Authority leaving no in year pool Covid pressure.

Resolved:

1.    That £3.8m overspend position being forecast in relation to non-Covid pool budgets as at the Outturn, funded from increased contributions from the Local Authority be noted;

2.    That it be noted that the Outturn, £3.1m of Covid costs are forecast against Health and Social Care Pool Budget. This would be wholly funded from Government emergency funding received by the Local Authority, leaving no in year pool Covid pressure.

Reasons for decision:

This report updated the LB on the Health and Social Care pooled budgets for 2022/23 in line with National Health Service England (NHSE) guidelines and the Greater Manchester (GM) Health and Social Care Partnership requirements. As part of operating a pooled budget regular monitoring reports are required.

The BCF has been excluded from the pooled reporting and would be reported separately to LB in line with NHSE requirements for reporting each quarter.

Alternatives considered:

The operation of a formal pool in 2022/23 builds on the shadow pool that was operated by the ICB in 2017/18 and is in line with previous years reporting; therefore, there are no alternatives to consider.

To consider  a report of the Locality Director of Strategic Performance – Health & Social Care – Item for information and decision

The Joint Committee considered a report of the Locality Director of Strategic Performance Health and Social Care which sought to inform of the financial outturn position for the Better Care Fund (BCF) for the financial year 2022/23.

The report author presented the information and drew the attention of the Board Members on the overspend on Social Care Services which was mitigated by a underspend against the equipment loan store. Members were also asked to note the underspend against capital budgets in relation to the Disabled Facility Grant (DFG) and Health Integration Hubs.

Resolved:

1.    That it be noted that the revenue spend for 2022/23 was on budget;

2.    That it be noted that there was an overspend on Social Care Services which was mitigated by a underspend against the equipment loan store;

3.    That the £82k equipment loan store budget underspend be allocated to funding of Social Care Services to mitigate the reported pressure in Adult Care for the increased costs in placements;

4.    That the underspend against capital budgets of £1,492k in relation to the Disabled Facilities Grant (DFG) and £71k the Health Integration Hubs be noted and that, under Council procedures, the carry forward of any unspent capital budgets to 2023/24 be agreed.

Reasons for decision:

The Locality Board have responsibility for the BCF budget as mandated in the BCF Policy Framework and Planning Guidance. The NHS GM ICB and the Council have delegated responsibility for the BCF to the Locality Board. The revised 2022/23 budget for the BCF was agreed by the ICB in May 2022, this report provides an update on the forecast position against those budgets.

Alternatives considered:

It is a requirement of the NHSE guidance to produce a budget for 2022/23 which the ICB approved at its May 2022 meeting. This report updates the monitoring against the 2022/23 budget which is a requirement of the Section 75 agreement. Therefore there are no alternatives to consider.

To consider a report of the Locality Director of Strategic Performance – Health & Social Care – Item for decision

The Joint Committee considered a report of the Locality Director of Strategic Performance – Health and Social Care which informed of the Health and Social Care Pooled fund opening budget and risk share arrangements for 2023/24. The Local Authority 2023/24 balanced budget was approved by Full Council in March 2023.

Resolved:

1.    That the Health and Social Care Pooled fund opening budgets for 2023/24 be approved;

2.    That it be noted that the risk share arrangements for the Pooled fund remained paused for 2023/24.

Reason for decision:

The Locality Board have responsibility for the Health and Social Care Pooled budgets for 2023/24 in line with National Health Service England (NHSE) guidelines and the Greater Manchester (GM) Health and Social Care Partnership requirements. As part of operating a pooled budget regular monitoring reports are required.

The Better Care Fund (BCF) has been excluded from the pooled reporting and would be reported separately to the Locality Board in line with NHSE requirements for reporting each quarter.

Alternatives considered and rejected:

The operation of a formal pool in 2023/24 is in line with the requirements of the GM Health and Social Care Partnership and builds on the shadow pool that was operated by the Integrated Commissioning Board in 2017/18. This is in line with previous years reporting; therefore, there were no alternatives to consider.

To consider a report of the Locality Director of Strategic Performance – Health & Social Care – Item for decision

Board Members considered a report of the Locality Director for Strategic Performance - Health and Social Care which sought to inform of the proposed budget for the Better Care Fund (BCF) for the financial year 2023/24.

The report author informed that the figures in table 2 of the report included the 2022/23 Disabled Facilities Grants (DFG) allocation and took account of the 2022/23 capital budgets forecast to be carried forward of £1,492k.

Board Members asked and received clarification on the NHS Greater Manchester (GM) Integrated Care Board (ICB)’s contributions to the BCF’s schemes for 2023/24. There was uncertainty on whether the level of contribution from the ICB would continue at the same level as previous years. Officers were in constant dialogue with the ICB which awaited to hear from the national team.

Resolved:

1.    That the revised revenue and capital budgets for the BCF for 2023/24 be approved;

2.    That the proposed allocation of the DFG budget in Table 2 of the report, with the flexibility to transfer budget between the various schemed as necessary be approved.

3.    That responsible officers liaised on a weekly basis with the ICB about certainty on the level of contribution to the BCF’s schemes for 2023/24.

Reason for decision:

The Locality Board have responsibility for the BCF budget and mandated in the BCF Policy Framework and Planning Guidance. The NHS GM ICB and the Council have delegated responsibility for the BCF to the Locality Board. 

Alternatives considered a rejected:

It is a requirement of the NHSE guidance to produce a budget for 2023/24. The report provided details of the proposed 2023/24 budget, taking into account the known changes in Better Care Fund Allocations. Therefore, there were no alternatives to consider.

To consider a report of the Interim Director of Integration and Transformation  - Item for decision

The Joint Committee gave consideration to a report of the Interim Director of Integration and Transformation which sought approval of the implementation of the detailed Managing Conflict of Interest Procedure for HMR Locality Board and its governance substructure.

Resolved that the detailed Managing Conflict of Interest Procedure for HMR Locality Board and its governance substructure be approved.

Reason for decision:

Approving the implementation of the Conflict of Interest Procedure would ensure HMR Locality Board meets its duties to manage any interests appropriately in line with NHS GM Conflict of Interest Policy and the 1972 Local Government Act, the Localism Act 2011, the 2012 Executive Arrangements Regulations and the 2014 Openness of Local Government Bodies Regulations.

This would ensure openness and transparency in the decision making process and a register of HMR Locality Board members interests would be available for review by NHS GM IC or any member of the public should they so request.

Alternatives considered and rejected:

To do nothing and each member abide by their respective organisations code of conduct in the management of conflicts of interest, which varies dependent on sector, was considered. However, this would result in no central register and an inability to manage interest proactively and appropriately.

To consider a report of the Locality Director of Strategic Performance  – Health & Social Care - Item for decision

Board members considered a report of the Locality Director of Strategic Performances Health and Social Care which sought approval of the Heywood, Middleton and Rochdale (HMR) Locality Board Assurance Framework (BAF) opening position for 2023/24.

The report author informed that a full refresh of the BAF for 2023/24 had been undertaken to ensure that the new strategic risks identified within the BAF were aligned to the locality strategic objectives. Appropriate risk scores had been identified to reflect the position of the locality as it moved in 2023/24.

The Senior Officer informed that six major strategic risks would be reported on a quarterly basis as wells operational risks.

Resolved:

1.     That the HMR Locality BAF for 2023/24 be approved;

2.    That it be noted that the Locality Board is required to escalate strategic risks scored 15 or above to NHS GM ICB quarterly, with the next report due on 31^st May 2023. The strategic risk scoring 15 and above to be escalated to GM ICB were included in section 5.6 of the report.

Reason for decision:

The HMR Locality BAF for 2023/24 has been developed to bring together in one place the key risks that if not mitigated threaten the achievement of the agreed locality strategic objectives.

Alternative considered and rejected:

Not having a BAF in place, would preclude the ability to monitor risks and escalate them, providing assurance on the work being undertaken to mitigate and control risks.  

To consider a report of the Place Based Primary Care Commissioning Committee – Item for information

The Joint Committee considered a report of the Heywood, Middleton and Rochdale Place based Primary Care Commissioning Committee (PCCC) which sought to inform of the risks regarding Enhanced Access mobilisation and Additional Roles Reimbursement Scheme (ARRS) recruitment for 2023/24.

The Locality Director of Strategic Performance Health and Social Care presented the report and informed of the discussion that had taken place at the PCCC concerning Access to Primary Care, Locally Commissioned Scheme new approach for 2023/24, Workforce and Risk register. 

Board Members highlighted that the Primary Care Network’s five year contract was coming to an end and the current resources baseline needed to be utilised by the end of October in order to inform the commissioners’ work in September to determine the new baseline.

Board members sought and received clarification on the forecast under delivery of approximately 500 hours in total across three HMR Primary Care Networks for 2022/23. Board Members learned that this concerned central Rochdale and was due to estate capacity. However, the Joint Committee received assurance that providers were working to ensure that the target was achieved by the end of August.

Resolved that the update be noted.

To consider a report of the Interim Director of Integration and Transformation – Item for information

The Joint Committee considered a report of the Interim Director of Integration and Transformation which informed of the engagement projects that had been funded through a bidding process for Voluntary, Community, Faith and Social Enterprise (VCFSE) organisations.

The report author informed that funding ranged from £4k to £20k, with 25% funding held back until the end of the projects. A document incorporating all projects had been presented to the Local Care Organisation Board and would be shared with the Locality Board in due course. The report author stressed that this project had been an excellent opportunity to work with the voluntary sector in the Borough and to support engagement with residents that would not normally engage.

The Board agreed on the importance of embedding the outcomes of the engagement exercise in the work that the Locality Board and its sub-groups take forward, making coproduction possible.

The Board noted the importance of accessing information and signposting at Neighbourhoods/Townships level, especially for the hard to reach groups.

The Board discussed the possibility that all Primary Care Networks could work with the VCFSE sector to identify hard to reach groups and variables across Neighbourhoods/Townships.

The Board also noted that a Neighbourhood Engagement Event was being organised and would take place in the near future.

Resolved:

1.    That the content of the update be noted;

2.    Primary Care Networks’ Business Support Officers be included in the Action Together’s monthly newsletter;

3.    That information concerning the Neighbourhoods event be circulated to all Board Members;

4.    The document incorporating all VCFSE engagement projects be shared with all Board Members.

To consider a report of the Director of Public Health  -Item for information and decision

The Joint Committee considered a report of the Director of Public Health which sought to inform of the activity of the Engagement and Insight Sub-Group. The Sub-Group had met for the first time in January 2023. The report also sought approval of the Terms of Reference of the Sub-Group which had been refreshed between January and March 2023.

The report author informed that the Engagement and Insight Sub-Group would provide a platform for engagement and insight and to develop mechanisms and approaches to meet statutory duties and operating in line with the Coproduction principles: Recognising People as Assets, Building on people’s capabilities, Developing two way, reciprocal relationships, Encouraging peer support, Blurring boundaries between delivering and receiving services, Facilitating rather than delivering.

The report author added that the Sub-Group had raised concerns regarding the lack of capacity and financial support across the system to meet these duties. The Sub-Group would look at best practices whose common denominator would be an innovative and cooperative ethos.

Board members reiterated the importance of prevention and young people’s mental health.

Resolved:

1.    That the update be noted;

2.    That the Terms of Reference of the Engagement and Insight Sub-Group (as amended between January and March 2023) be approved.

To consider a report of the Locality Associate Director Nursing, Quality and Safety – Item for information

The Joint Committee considered a report of the Locality Associate Director Nursing and Safety which sought to update on the work of the Quality, Safety and Safeguarding Sub-Group.

The Adult Quality, Safety and Safeguarding Lead presented the report and addressed the question and comments of the Joint Committee. The Officer provided an overview of some of the activities carried out by the Sub-Group such as engagement activities with the Local Authority and HealthWatch Rochdale, the dashboard to report/record site visits and work with providers on implementation of patient safety framework.

The presenter drew the attention of the Board Members on the Greater Manchester Quality Strategy included in Appending 1 of the report which had been circulated for consultation. Board Members could send their comments on the draft to the Adult Quality, Safety and Safeguarding Lead to prepare a system response.

Board Members also noted that the content of this report concerned safeguarding and quality mainly from an NHS perspective, with no input from the Council’s Children’s and Adults Safeguarding Teams.

Resolved:

1.    That the information be noted;

2.    That Board Members send their comments on the draft GM Quality Strategy to the Adult Quality, Safety and Safeguarding Lead to prepare a system response to the consultation.

On behalf of the Board the Chair thanked Dr. Bodrul Alam for his contribution and dedication to the work of the HMR Locality Board.