The Integrated Joint Board (IJB) set up by Scottish Borders Council and NHS Borders is grappling with a set of problems while a proposal to amalgamate public services under the control of a single authority has hit the buffers.
These are among the topics covered by Audit Scotland's Best Value assessment of SBC which Not Just Sheep & Rugby has been revealing over recent days.
A section of the report which looks at so-called partnership working says the council's work with the local health authority 'could be improved'.
Audit Scotland comments: "A proposal for a single public authority was not progressed.
The council and NHS Borders serve the same geographical area and they have
worked well in partnership on a number of issues over time, such as their joint
appointment of the Director of Public Health, one of the first in Scotland.
"In
response to the Scottish Government’s national review of local governance in
2018/19, the council proposed the exploration of a single public authority for the
Scottish Borders area. It was described as a starting point for dialogue with
the Scottish Government and COSLA.
"However, whilst the proposal was reported to
full council in September 2018, it did not receive the full support of the
wider public sector community in Scottish Borders at that time and has not been
progressed."
Meanwhile the Scottish Borders Health and Social Care Integration Joint Board
recognises it has more to do and developed a detailed improvement plan, the report points out.
"The
Scottish Borders Health and Social Care Partnership Integration Joint Board
(IJB) assumed responsibility for the planning and commissioning of health and
social care services from April 2016. It includes adult social care, community
health services and those hospital services typically associated with the
emergency care pathway (also known as unscheduled care). It is jointly funded
by the council and NHS Borders, from which it also commissions services. The
IJB’s strategic plan for 2018–2021 was renewed in 2018/19.
"NHS Borders is at
level four out of five in the NHS performance scale(meaning ‘at significant
risk’). It received Scottish Government support of £10 million to help it break
even in 2018/19. A similar budget shortfall is anticipated in 2019/20. This has
serious implications for financial planning by the IJB, which has yet to set
its 2019/20 budget. It also has implications for the council, which is a
partner in the IJB and appoints members to its board.
"The IJB worked with the
council and NHS Borders to carry out self-evaluation and submitted a return to
the MSG (Ministerial Strategic Group) in May 2019. The self-evaluation was
carried out against proposals, with each proposal being assessed as either ‘not
yet established’, ‘partly established’, ‘established’ or ‘exemplary’. The IJB
evaluated itself as being not yet established in one area, partly established
in 15 areas, established in six areas and exemplary in none. The area assessed
as not yet established relates to agreeing budgets timeously. The IJB has
identified improvement actions it needs to take forward.
"The IJB’s governance arrangements would be strengthened by
regular attendance at board meetings
The IJB is governed by a board. Two meetings of the board,
at the end of 2018 and beginning of 2019, were inquorate (not enough board members
attended) and important decisions were deferred to subsequent meetings.
Inconsistent attendance at board meetings may indicate a lack of commitment and
it risks undermining the board’s effectiveness.
"Challenges have also arisen
from the rapid turnover of senior IJB officers. There have been four chief
officers since the IJB was established in 2016, and no permanent chief
financial officer. The lack of continuous leadership has impaired the IJB’s
progress. However, there is now continuity in the position of chief officer and
a refreshed effort by the council, NHS Borders and IJB to address their shared
challenges cooperatively."
NEXT: THE COUNCIL AND COMMUNITY EMPOWERMENT
No comments:
Post a Comment