Edinburgh Integration Joint Board Development session 11 August 2017

Aim of session To ensure all members of the Board have a shared understanding of: The background to and strategic intentions behind health and social care integration The different roles of the IJB, the Council and NHS Lothian and the relationship between them The arrangements for integration The role of IJB members

Programme Time Item 9.30 Welcome and introduction 9.35 Background to integration 9.40 How does it all work 10.20 Role of IJB members 11.10 Break 11.20 Finance 11.35 Performance 11.50 Expectations of meetings, development sessions and visits 12.00 Formal meeting

Strategic intent Christie Commission Report (2011) 20:20 Vision (2015) Public Bodies (Joint Working) Act (2014) Health and Social Care Delivery Plan (2016) Prevention Performance People Partnership Integrated health and social care Prevention, anticipation, supported self-management High quality, safe, person-centred Safe return home asap Health and social care services are: Integrated Person-centred Planned and led locally Improved quality, safety and outcomes Preventative Efficient Better care Better health Better value through integration clinical health strategy public health reform NHS Board reform

What is an IJB? A distinct legal entity Associated powers and duties with its ‘integration functions’ Responsible and accountable for its own actions Compliant with many Acts and Regulations

Membership of the IJB Membership 10 voting members (5 CEC elected members, 5 NHSL Board Members Chief Officer, Chief Finance Officer, Chief Social Worker, Chief Nurse, Medical Director A registered medical practitioner who is not a GP Citizens members Staff representatives Chair rotates between CEC and NHSL every 2 years Term of office Liability

What the legislation covers Integration model Integration scheme IJB operational arrangements Functions and services to be delegated National standards Integration planning and delivery principles National Health and Wellbeing Outcomes Strategic plan Locality focus Strategic Planning Group Directions Finance Financial plan to be produced annually Accounts to be published annually Performance Performance report to be produced annually by 31st July

Main delegated functions and services Adult Social Care Services Community Health Services Hospital Based Services Assessment and Care Management-including Occupational Therapy services Residential Care Extra Care Housing and Sheltered Housing (Housing Support provided) Intermediate Care Supported Housing-Learning Disability Rehabilitation-Mental Health Day Services Local Area Coordination Care at home services Reablement Rapid Response Telecare Respite services Quality assurance and Contracts Sensory impairment services Drugs and alcohol services District Nursing Services relating to an addiction or dependence on any substance. Services provided by Allied Health Professionals (AHPs) Community dental service Primary medical services (GP)* General dental services* Ophthalmic services* Pharmaceutical services* Out-of-Hours primary medical services Community geriatric medicine Palliative care Mental health services Continence services Kidney dialysis Prison health care service Services to promote public health *Includes responsibility for those aged under 18 Accident and Emergency General medicine Geriatric medicine Rehabilitation medicine Respiratory medicine Psychiatry of learning disability Hospital services provided by GPs Mental health services provided in a hospital with exception of forensic mental health services Services relating to an addiction or dependence on any substance

Hosted services Hosted services Edinburgh Rehabilitation Sexual health Substance misuse East Lothian Complex care Unscheduled care Mid Lothian Art therapy Dietetics West Lothian Clinical psychology Community dentistry Podiatry NHS Lothian Hospital based learning disability services Hospital based mental health

Services delegated to Edinburgh IJB and managed by NHS Lothian Set aside services Services delegated to Edinburgh IJB and managed by NHS Lothian Accident and Emergency Cardiology Diabetes Endocrinology Gastroenterology General medicine Geriatric medicine Infectious diseases Rehabilitation medicine Respiratory medicine Therapies

Legal responsibilities of the IJB Public Records (Scotland) Act 2011 Records management Data access requests Freedom of Information (Scotland) Act 2004 Freedom of Information requests Publication scheme Equality Act 2010 Mainstreaming report Equality outcomes Equality impact assessments Climate change reporting requirements Annual reporting requirement Ethical standards in public life Code of conduct

How does it work in practice?

Role of the IJB £s £s NHSL EIJB CEC Directions Directions £s £s CO NHSL and CEC delegate budgets and services to EIJB £s £s NHSL EIJB CEC EIJB produces strategic plan and issues directions with associated budget and performance measures for delivery of services to NHSL and CEC Directions Directions £s £s CO Strategic Planning Operational oversight Performance Management

Role of the HSCP EIJB CO NHSL CEC EHSCP Staff and budget Staff and Operational delivery Set aside services Hosted services

How it fits together Integration Scheme

Governance arrangements

The IJB and its subgroups Integration Joint Board Audit and Risk Group Performance and Quality Group Professional Advisory Group Strategic Planning Group Provides the Board with assurance that governance, risk and audit arrangements are in line with good practice governance standards in the public sector. Provides assurance to the Board that the performance and quality of delegated functions are being effectively assessed and managed. Provides professional advice and opinion to the Board and allows health and social care professionals to influence the strategic planning of services. Provides a means of enabling stakeholders to influence the planning and delivery of delegated services.

Role of the Chief Officer Chief Executive CEC Chair EIJB Chief Executive NHSL Chief Officer

EHSCP Senior Management Structure Chief Officer Edinburgh Health and Social Care Partnership Locality Manager NW Chief Strategy and Performance Officer Strategic Planning and Quality Manager Older People Mental Health & Sub Misuse Disabilities Primary Care Chief Nurse Chief Finance Officer Chief Medical Officer NE SW SE Hospital & Hosted Services Manager Strategic Planning Support Chief Executive NHS Lothian City of Edinburgh Council Edinburgh Integration Joint Board Chief Social Work Officer

EHSCP Operating model Monitoring Quality assurance Public protection Locality Manager NW NE SW Strategic Planning and Quality Manager Older People Mental Health & Sub Misuse Disabilities Primary Care Monitoring Quality assurance Public protection Service improvements

EHSCP Locality Structure Chief Officer Edinburgh Health and Social Care Partnership Locality Manager NW Locality Manager NE Locality Manager SW Locality Manager SE Hub Manager Hub Manager Hub Manager Hub Manager Cluster Manager x 2 Cluster Manager x 2 Cluster Manager x 2 Cluster Manager x 2 Mental Health and Substance Misuse Manager Mental Health and Substance Misuse Manager Mental Health and Substance Misuse Manager Mental Health and Substance Misuse Manager