Highland NHS Board
                                                                   3 February 2009
                                                                       Item 3.13(a)


                             COMMITTEE MEETING

              Notes of Meeting held on Friday, 24th October 2008
                       @ 10:00 am in Rooms JO3, 5, 7
    Mid Argyll Community Hospital & Integrated Care Centre, Lochgilphead

Chair:   Bill Brackenridge, Chair of Argyll & Bute CHP
Note of Action Points: Clair McCann, Admin Officer - Argyll and Bute Council

James D M Robb, Head of Adult Care – Argyll and Bute Council
Tricia Morrison, Development Officer, Carers Network
Councillor Donald McIntosh, Spokesperson for Social Services – Argyll & Bute
Anne Clark, Non-Executive Director, NHS Highland
Susan Dawson, Health Improvement Officer, Argyll and Bute Council
Susan Spicer, Argyll and Bute CHP
Douglas Hendry, Director of Community Services, Argyll and Bute Council

In Attendance:
Allen Stevenson, Service Manager – Mental Health – Argyll & Bute Council (agenda
items 4/11)
Claire Wood, on behalf of the Argyll and Bute CHP (agenda item 8)
Pat Trehan, Service Manager, Joint Planning and Performance
Dionne Forrest, ISD and Mags McFadden (secondment) from Stephen Whiston’s

No. Item                                                                  Action
 1. Apologies/Introductions

     Apologies were received from Sally Reid, Derek Leslie, Dougie
     Dunlop, Councillor Walsh, Jan Baird, Malcolm McFadyen, Marion
     Power, Josephine Bown, and Pat Tyrrell. The meeting was not
     quorate and consequently it was agreed to use the meeting for
     general discussion and to identify actions for the December

     Pat Trehan, Joint Area Manager Planning & Performance was
     formally introduced to the group and also observers in attendance,
     Dionne Forrest and Mags McFadden were welcomed from ISD and
     Stephen Whistons Office.

No. Item                                                                      Action

2.    Transfer of Chair to Argyll and Bute Council

      Councillor Donald McIntosh will take over as Chair Person at the
      Committee Meeting of 19th December 2008.

3.    Matters Arising From Previous Minute (22nd August 2008)

      The previous minute was accepted as accurate.                            DD
      Anne Clarke enquired about the system of governance for
      Children’s Services. Agreed that a report will be presented to the
      February 2009 meeting.

      Standing Items:
3a.   Older people:

      Bill Brackenbridge to ensure a clear steer and statement of intent
      in relation to surplus NHS continuing care beds is provided for the
      local authority from Derek/Josephine re Commissioning Plan/Older
      Peoples Services. Jim Robb to discuss with Derek.                   BB/DL/JR

3b.   Delayed Discharge:

      Noted the report provided. There are difficulties in maintaining a
      delayed discharge target of zero.

      There followed a discussion in relation to 71(x) exemption number,
      which are generally considered to be high. However, noted that
      66% of clients coded have moved out of the code providing
      evidence of good turnover and audit process. This matter will be
      discussed at a future meeting of the partner’s Chief Executives.

      Pat Trehan will work with the Joint Improvement Team to produce
      a monthly report regarding Delayed Discharge and Code 71x.

3c.   Emergency Admissions:

      The census carried out over a 12-week period shows an
      incomplete picture of emergency admissions with some anomalies.
      More information is required from the Vale of Leven and an
      updated version of the report is required. Likewise the information
      requires to be tied into service activity, ICT , Telecare and Delayed
      Discharge funded services in terms of impact on patterns of
      admissions. Mags McFadden and Dionne Forrest offered their
      assistance with stats/figures etc as required. The paper regarding
      emergency admissions will not be discussed at the meeting of 19th
      December as there is currently work with the Joint Improvement
      Team in progress.                                                        JB

No. Item                                                                    Action

3e.   Douglas Hendry reported he is pleased with progress made thus          DH
      far and the next meeting is scheduled to take place on 21st January
      2009. An further paper will be available to December meeting.

3f.   Douglas Hendry reported gaps in telecare for a number of older        M McF
      persons. The Police are at times used as a default service.
      Malcolm McFadyen to take the matter forward and provide an
      update to\the December meeting

3g.   The SWIA six monthly follow up visit provided positive feedback        JR
      across the board. SWIA will return during January 2009 for a
      further update. There will be a further update at the December
      Committee Meeting.

4.    Assessment & Care Planning:

      The paper requires to be properly signed off by CHP managers
      and the CHP management team. Allen will report back to the
      committee on 19th December 2008.                                       AS

5.    Resource Transfer and Delayed Discharge Financial Update

      There are no significant variances and the budget has been
      managed appropriately. George Morrison is comfortable with this.

      There will be a further quarterly update, which will be provided at    JR
      the Committee meeting in February.

6.    Integrated Care Teams

      The paper from Susan Spicer will be presented at both CHP              SP
      committee meetings in November and will come back to the
      December strategic meeting for discussion in relation to a joint
      statement being issued to staffs regarding the progress made to

7.    Project Initiation Document – Pilot E-SSA

      Susan sought approval to progress with the proposals so that work
      can be completed by the end of March 2009.

      Douglas Hendry was happy to sign the paper off on the basis that
      Derek Leslie was also in agreement before the paper is presented      DH/DL
      to the NHS Highland Committee.

8.    Integrated Occupational Therapy Service Specification

      Claire Wood had drawn up an implementation plan and described
      the key points within the service spec.

No. Item                                                                     Action
    It was decided that the paper should be presented to the
    December meeting for formal approval and that work could
    continue meantime.

      Clarity and further discussion is required regarding the                CW
      management of the system.          There requires being more
      explanation regarding HEAT targets also.

9.    Jeanie Deans Accommodation
      George Morrison highlighted that there are previously unidentified
      capacity issues that will limit the number of staff able to be based    GM
      at the Jeannie Deans. The proposal to move all adult care social
      work staff from Lomond St is no longer deemed achievable.

      George Morrison to re-convene planning group and report to
      December meeting.
10.   Dementia Service Development Update

      John Dreghorn’s presence is required at the December meeting to
      present the proposals for community services noted in the report.
11.   Learning Disability Integration

      Allen Stevenson noted that the integration had progressed as
      Allen reported that seven staff road shows had been carried out
      and that there had been positive feedback from staff.

12.   A.O.C.B

      Integrated Equipment Services – Maintenance and Inspection

      There is equipment in the community, which has failed to be            Action
      maintained or inspected. Noted that a proposal to commission           JB/LG
      maintenance and inspection service had quoted £143K per annum.

      Noted that this is a risk to\operational services that require to be
          Funding will need to be found within existing resources.

            Alternative options require to be investigated and presented
             to December meeting.

      Next meeting will be held on Friday 19th December at 10am in the
      Mid Argyll Community Hospital and Integrated Care Centre in
      usual rooms, JO3,5 7.      The Chairman will now be Councillor
      Donald ‘Skye’ McIntosh, Argyll and Bute Council.


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