EAST AYRSHIRE HEALTH AND SOCIAL CARE PARTNERSHIP SHADOW INTEGRATION BOARD 24 APRIL 2014

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1 EAST AYRSHIRE HEALTH AND SOCIAL CARE PARTNERSHIP SHADOW INTEGRATION BOARD 24 APRIL 2014 PROPOSALS FOR PARTNERSHIP MANAGEMENT AND GOVERNANCE ARRANGEMENTS PURPOSE Report by Director of Health and Social Care 1. The purpose of this report is to seek endorsement of: (i) Senior Management and Governance arrangements for East Ayrshire Health and Social Care Partnership; (ii) A scheme of Joint Protocols and Principles for the Recruitment of Senior Posts within the Partnership. 2. In June 2013, East Ayrshire Council and NHS Ayrshire and Arran approved the establishment of a Health and Social Care Partnership in a Body Corporate model of integration. 3. At that time plans for integration were agreed that included establishment of a Transitional Integration Board that would make arrangements for the establishment of Shadow Integration Board by April 2014.This would include: Membership of the Shadow Integration Board Agreement on services to be delegated by the Council and the NHS Board to the Partnership and The appointment of a Director of Health and Social Care to act as Chief Officer of the Partnership 4. The Transitional Integration Board has now fulfilled its role: Membership, Terms of Reference and Standing Orders of the Shadow Integration Board have been agreed, with due regard to emerging national policy guidance and local requirements. The detail of services to be delegated to the partnership was substantially agreed in March 2014, with a number of reviews to be completed in the shadow year. The Director of Health and Social Care was appointed in February The Shadow Integration Board will from April 2014 until March 2015: Oversee the management and delivery of services delegated to the Partnership Work with the parent bodies in development of the legal agreement (Integration Scheme) that will set out the detail of integration including what resources are delegated to the partnership and the outcomes that are required Develop the Strategic Plan that will set out how the priorities and outcomes will be delivered. Make arrangements to full legal integration from April 2015.

2 6. In order for the Shadow Board and subsequently the full Integration Joint Board to fulfil their function robust arrangements are required for the Leadership, Management and Governance of services delegated to the Partnership. The HSCP Director has been working with key individuals within the NHS and the Council in this regard to develop proposals for joint service delivery. 7. There are essentially 3 elements to the proposals: Leadership and Management of the Service Professional and Clinical Governance of the Service Planning, Development and Business / Resource Support. LEADERSHIP AND MANAGEMENT OF THE SERVICE 8. It is envisaged that all health and social care functions will be managed by a joint management team. The premise is that joint management responsibility and authority over NHS and Council resource will allow the HSCP to focus on agreed priorities and outcomes and develop flexible services around the needs of people within East Ayrshire. 9. As the HSCP takes operational responsibility we would expect to see: Joint management replacing existing management arrangements. Merged support arrangements. Co-location of staff and service delivery points 10. While the management arrangements would encompass the totality of services within health and social care (some services do not require integrated delivery), it will take time to integrate the delivery of services. 11. Key considerations in delivering the partnership priorities will be: Service delivery is focussed on the outcomes for those who need service. Shift resources to prevention and earlier intervention. Services are designed to maximise access and independence. Services continue to be delivered at locality level. We should strive to provide holistic care based on sound evidence. 12. The management proposal for the HSCP will replace existing posts within Social Services, they will also replace core functions which were previously located in pan- Ayrshire NHS posts. These posts combine responsibility for health and social work services under specific Heads of Service posts. This allows flexibility in managing services across the partnership and would facilitate the removal of barriers between services. 13. The two posts are the Head of Service, Community Health and Care Services and the Head of Children s Health, Care and Criminal Justice Services. Both posts will manage Social Services and Health services and provide strategic leadership across a range of internal Council and NHS interfaces and external partnerships. A list of service responsibilities is identified on the diagram at Appendix Some services particularly but not exclusively in the NHS are not easily disaggregated across the three partnerships or there may be good professional or clinical governance reasons not to split services. It is therefore proposed that some services are managed on a lead partnership agreement where one HSCP manages and provides professional leadership of a pan-ayrshire service. There will

3 be a number of these arrangements across the three Ayrshire HSCPs. Within the proposed East Ayrshire HSCP Senior Management Team provision for the management and leadership of such services has been outlined with detail to follow service review over the next few months. 15. It is proposed that the partnership will appoint a Head of service with responsibility for Lead Partnership Services. The Head of Service will also be expected to lead the review of these partnership services identified for 2014/15. The Head of Service will be responsible for leadership of pan-ayrshire strategic planning and liaison with the North and South partnerships for delegated services. PROFESSIONAL AND CLINICAL GOVERNANCE OF THE SERVICE 16. To supplement line management functions, arrangements are required to monitor and develop professional and clinical governance within the partnership. This includes Social Work, Clinical Leadership, Nursing and Allied Health Professionals. 17. The role of the Chief Social Work Officer (CSWO) was updated in Scottish Government guidance issued in Every local authority requires to appoint a professionally qualified CSWO in line with Section 3 of the Social Work (Scotland) Act The CSWO is a proper officer in relation to the social work function. The CSWO must ensure the provision of effective, professional advice to the Council on all aspects of social work activity including corporate parenting, child protection, adult protection and the management of high risk offenders. The CSWO also takes final decisions on behalf of the local authority in relation to adoption, secure accommodation, guardianship and other statutory duties from time to time. 18. The CSWO has a responsibility to contribute to reports to Council and provide independent comment and to prepare an annual report on all of the statutory governance and leadership functions of the role. 19. The HSCP management proposal at Appendix 1, proposes the CSWO will sit at Head of Service level. While they would report directly to the Director of the HSCP, they would also have a line of accountability to the Chief Executive of the local authority in relation to their CSWO function. The CSWO would support the Chief Executive in their role as Chair of the Chief Officers Group. 20. Within the NHS professional governance arrangements are also required for medicine, nursing and allied health professionals (AHPs). It is proposed that the partnership will appoint a Clinical Lead and similar to the arrangement for CSWO, will appoint a Senior Nurse and AHP to undertake professional leadership which they will discharge in addition to their substantive role. 21. These posts will provide the professional leadership across the HSCP, ensuring robust clinical and professional governance arrangements. 22. While day to day line management accountability will be through the HSCP Director, the Clinical Director, Lead Nurse and Lead AHP will have a professional accountability to the Health Board Medical Director, Nurse Director and AHP Associate Director. PLANNING, DEVELOPMENT AND BUSINESS / RESOURCE SUPPORT 23. The legislation requires the preparation and delivery of clearly articulated strategic plans. The planning landscape is complicated; it needs to reflect local and national

4 priorities for the partnership and parent bodies as well as service users, carers and third sector views. In addition to this we need to ensure our employees and primary care contractors have a clear voice. 24. The Health and Social Care Partnership has specific duties in respect of Strategic Planning and lead responsibility to co-ordinate and achieve the Health and Wellbeing Outcomes of the Community Planning Partnership. It also required to develop and report on a suite of outcome indicators that demonstrate performance and improvement at a local and national level. 25. The Strategic Plan for the partnership will relate directly to the CPP plans, the NHS Local Delivery Plan, Council Plans including, Housing Plans and joint strategies with Education for children and young people and also currently the Community Justice and Criminal Justice partnership plans. 26. There will be significant work to undertake in relation to streamlining and developing performance management frameworks and functions for the partnership. 27. It is therefore proposed that a post dedicated to planning and performance is included within the Senior Management Team for the HSCP. 28. The Health and Social Care Partnership will have responsibility for significant financial resources (circa 140M) and Human Resources (circa 2,000 employees). There will also be responsibility for facilities including community hospitals, health centres, social care services and office accommodation. This provides a duty in terms of reporting and advice within the partnership and also close liaison with parent bodies. 29. The management responsibility of Business Administration is split between a Principal Manager for Finance and one for Business Support. 30. As the Bill progressed through Parliament there were amendments included in respect of financial governance and, in particular, the role of the local authority Section 95 Officer. The final modification was the introduction of new arrangements in respect of the financial governance of the Integration Joint Board. 31. The Chief Officer is accountable for all matters that relate to the Integration Joint Board, and they enable the Integration Joint Board to appoint an officer for matters of financial administration. The effect is to allow the Integration Joint Board to place financial accountability in the hands of a finance professional, if the Board agrees that that is appropriate, which will strengthen the financial governance of the Integration Joint Board. 32. Further work will be undertaken during 2014 by the Scottish Government, COSLA and professional associations to look at detailed regulations and this will support the work that has already been undertaken in partnership between the NHS and East Ayrshire Council Finance Services. 33. Current guidance advises that the Integration Joint Board should appoint an officer to be responsible for the administration of its financial affairs, referred to as the Integration Joint Board Financial Officer. This officer will ensure that appropriate Financial Governance arrangements are in place and will provide the necessary professional advice to the Board and to the Chief Officer The development of financial governance and financial management arrangements are continuing and involve a number of finance officers from the three Ayrshire councils and NHS Ayrshire and Arran working together on a number of workstreams. In order to ensure

5 that these are managed in a consistent and dedicated manner for the East Ayrshire partnership, it is proposed that a specific post of Senior Manager Finance be established with a remit to co-ordinate work around Financial Governance & Financial Planning, Financial Controls & Assurance and Financial Management & Financial Reporting between NHS Ayrshire and Arran and the Council to ensure that the arrangements are progressed and that the outcome meets the requirements of the Chief Financial Officers of both organisations. It is envisaged therefore that this will be a temporary post for one year in the first instance.in terms of employees there is responsibility for Health and Safety, Risk Management and robust links with both Council and NHS Human Resource Services. 34. There is also a responsibility for effective administrative and information systems to ensure effective support to meet the needs of the Partnership and services therein. The integration where appropriate of such services is likely to provide benefits in terms of both better outcomes for individuals and efficiencies in resourcing that can be directed to agreed priorities. 35. The Business Management post will work with colleagues in the NHS and the Council to develop appropriate business support arrangements. There is also a requirement to ensure robust arrangements for business continuity and effective engagement with civil contingency planning. While the proposed arrangement differs from current arrangements within the NHS, it is critical that dual responsibilities are held by postholder within the partnership. The alternative is double resourcing and unmanageable. 36. At this stage it is proposed that we move to appoint the Senior Management Team and then require Heads of Service, Senior Managers and professional leads to develop management and leadership proposals for implementation later in 2014/15. GUIDING PRINCIPLES & AGREED PROCESS FOR SENIOR JOINT APPOINTMENTS 37. Joint appointments are an important element of the delivery of the integration agenda as outlined in the Public Bodies (Joint Working) (Scotland) Act 2014 and play a significant role in supporting health and local government agencies to work together. 38. The purpose of joint appointments is to help organisations to work more collaboratively and achieve shared objectives. In social care and health sectors, joint appointments can help deliver partnership working, integrated management and planning, and where appropriate service integration. 39. The Human Resource services of NHS Ayrshire & Arran and East Ayrshire Council (in conjunction with North and South Ayrshire Council) have developed a set of Guiding Principles and Agreed Processes for Senior Joint Appointments. 40. The application of these principles will guide the development and appointment of new structural tiers as integration is established and embedded. The principles will be applied to the small number of new senior joint management appointments which will be put in place to directly support the Directors of Health and Social Care. 41. By their very nature of operating across the NHS and the local authority, these new senior joint posts require a complex set of shared competencies that reflect the complexity of integration and an ability to operate across organisational boundaries.

6 These new and separate arrangements are agreed to be applied solely to senior joint appointments, where all candidates for such posts will be assessed against the competency framework for the post concerned. 42. The scope of the Principles include: Organisational Structure Development and Approval Job Description & Person Specification /Job Role Evaluations Eligible Pool Identification Recruitment &Selection Appointments Trade Union/Local Partnership Involvement 43. NHS Ayrshire and Arran have had local partnership input to the development of these principles and there has been consultation in the Local Authority with the relevant Trade Unions. POLICY AND LEGAL IMPLICATIONS 44. The proposals within this report will support the Health and Social Care Partnership and parent bodies deliver on the Public Bodies (Joint Working) Scotland Act 2014 and also maintain existing duties to deliver on policy and legislative requirements for the delivery of Community Health and Social Work Services. HUMAN RESOURCE IMPLICATIONS 45. The existing schemes of delegation in the NHS and Council differ at present in relation to authority to agree Departmental Structural changes. Within the NHS this is delegated to the Chief Executive and in the Local Authority this requires endorsement of Council. It is intended if the proposals within this report are approved by SIB then they will be presented to East Ayrshire Council for consideration on 28 April The proposed management arrangements will impact on a small number of senior officers across services. The Guiding Principles are developed as a fair and transparent process for progressing appointments. FINANCIAL IMPLICATIONS 47. The overall cost of the management arrangements for the partnership will be met from existing Council and NHS resources utilised for the management and governance of Community Health and Social Care services. 48. COMMUNITY PLANNING IMPLICATIONS The comprehensive review of the Community Plan will be completed during 2014 / The role of the Health and Social Care partnership will be integral to delivering the Health and Wellbeing priorities. RISK IMPLICATIONS 49. The principal risks to the delivery of proposals within this report are:

7 (i) The timescales for the recruitment process (Interim management arrangements are in place) (ii) The availability of suitable candidates to meet the requirements of the senior roles. EQUALITIES IMPLICATIONS 50. The recruitment policies of both East Ayrshire council and NHS Ayrshire & Arran seek to ensure full legal and moral compliance equalities legislation. RECOMMENDATIONS 51. It is recommended that the Shadow Integration Board: (i) Notes progress of the Transitional Integration Board in delivering required arrangements for the management and delivery of services in the Shadow integration period; (ii) Endorses the proposed management arrangements for the Health and Social care Partnership at Appendix 1 and notes these will be presented to East Ayrshire Council on 28 th April 2014; (iii) Endorses the Guiding Principles and Agreed Process for Senior Joint Appointments at Appendix 2 and notes these will be presented to East Ayrshire Council on 28 th April 2014; and (iv) otherwise note the contents of the report. Eddie Fraser Director of Health and Social Care 7 April 2014 BACKGROUND PAPERS For more information on this report please contact Eddie Fraser, Director of Health and Social Care. Tel: IMPLEMENTATION OFFICER Eddie Fraser, Director of Health and Social Care

8 Chief Executive Officer East Ayrshire Council CSWO Health and Social Care Director [Chief Officer] Chief Executive Officer NHS Ayrshire & Arran Appendix 1 *Head of Service Children s Health, Care and Justice Services Children & Families SW Localities Services Family Support and Young People Services Intensive Support Services Corporate Parenting Children s Houses Fostering & Adoption Secure Care / External Commissioned Care Community Children s Services Health Visiting School Nursing Children with Disabilities Service Strategic Liaison with Education/Early Years/Police Child Protection MAPPA Justice Services Violence Against Women Services *Head of Service Community Health and Care Services Locality Community Care Teams Day Services Care at Home Care Homes Physical Disability Sensory Impairment Services District Nursing Frail Elderly Services EACH Kirklandside Hospital Purchasing Budget Acute Strategic Liaison Adult Support & Protection. Housing Support Services Mental Health Services Learning Disability Services Addiction Services Telehealthcare *Head of Service Lead Partnership Out of Hours Social Work Services Out of hours Nursing services NHS Board Medical Director Nurse Director AHP Associate Director Senior Manager Business Support Co-ordination/Liaison Human Resources Organisational Dev ICT Facilities Management Information Management Committee Administration Health Centres & Clinics. Communications Civil Contingencies Management of: Business Administration Contract Management & Procurement Health & Safety / Risk management Business Continuity Transactional Finance Senior Manager Finance Strategic Finance Capital Programme Senior Manager Planning & Performance Strategic Planning Locality Planning Commissioning Performance Reporting Asset Management Housing Strategic Liaison Health Improvement Learning & Development Financial Inclusion Strategy Self Directed Support Strategy * It is intended that the Council will appoint one of these post holders as CSWO Lead AHP East Ayrshire AHP Lead. Strategic Link and Leadership for all AHP Services in East Ayrshire. Professional Development Professional Advice Lead Nurse Nurse Leadership within HSCP HSCP Link to AND partnerships Clinical Standards Professional Development Professional Advice Associate Medical Director/Lead GP Professional Support to Medicine Clinical Governance Support & Liaison with contractors; GPs Pharmacists Dentists Optometrists

9 EAST AYRSHIRE, NORTH AYRSHIRE AND SOUTH AYRSHIRE HEALTH AND SOCIAL CARE PARTNERSHIP S Guiding Principles & Agreed Process for Senior Joint Appointments INTRODUCTION These principles have been jointly developed by a working group of HR professionals from the four Health and Local Authority organisations within Ayrshire and reflect The Joint Appointments Guide 2014, an updated guide to setting up, managing and maintaining joint appointments between health and local government in Scotland. Where possible, a consistent approach will be taken to the recruitment of Joint Appointments across all three partnerships. WHAT IS A J OINT AP P OINTMENT When separate organisations develop shared staffing arrangements to recruit someone to work for all the organisations, they have created a joint appointment. The purpose of joint appointments is usually to help organisations to work more collaboratively and achieve shared objectives. In social care and health sectors, joint appointments help deliver partnership working, integrated management and planning, service integration. 1 BACKGROUND AND CONTEXT Joint appointments are an important element of the delivery of the integration agenda as outlined in the Public Bodies (Joint Working) (Scotland) Bill 2013 and play a significant role in supporting health and local government agencies to work together. The Scottish Government at stage 3 amendment to the Bill have indicated that the body corporate model will not, at this stage, employ staff, however, they may by order, make provision enabling integration joint boards to employ additional staff other than the chief officer, at a later stage. These appointments will facilitate delivery of the services to improve outcomes by developing shared and complementary policies, procedures and plans within each partnership bringing different professionals together and strengthening lines of communication between the partner organisations. The application of these principles will guide the development and appointment of new structural tiers as integration is established and embedded. The principles will be applied to the small number of new senior joint management appointments which will be put in place to directly support the Directors of Health and Social Care. TRADE UNION/LOCAL PARTNERSHIP INVOLVEMENT NHS Ayrshire and Arran have had local partnership input to the development of these principles and the Local Authorities will consult with the relevant Trade Unions. AIMS & OBJECTIVES The main objective of the implementation of these principles across the partnerships is to enable a responsive, fair and reasonable approach to the joint appointments of senior staff in respect of the Integration of Health and Social Care. The NHS is the common partner

10 in all three Ayrshire Partnerships, and it is expected that each partnership combination, will follow this guide. This will be done in consultation with the relevant stakeholders. The aims of these guiding principles are to ensure: All relevant Stakeholders are identified and appropriately involved A fair, reasonable and consistent approach is taken for all joint appointments across all three partnerships The consultation process is supported These protocols are effectively communicated Service delivery is not compromised It is recognised that each organisation s policy for managing change has been developed to reflect their internal change arrangements and these will remain extant for internal health and local authority changes. However, these organisational specific policies are not appropriate to apply to the establishment of new senior joint appointments as part of the Integration of Health and Social Care Services. By their very nature of operating across the NHS and the local authority, these new senior joint posts require a more complex set of shared competencies that reflect the complexity of integration and an ability to operate across organisational boundaries. These new and separate arrangements are agreed to be applied solely to senior joint appointments, where all candidates for such posts will be assessed against the competency framework for the post concerned. PROCESS Organisational Structure Development and Approval The new structure will be developed by the Director for Health & Social Care in consultation with Chief Executives of the NHS and Councils involved in that partnership. The structure will reflect professional reporting arrangements and agreements where already in place The draft structures will be shared with the partnership forums and with relevant Trade Unions in the Councils involved in that partnership. After appropriate engagement within each organisation, the revised structure will then be approved by the Chief Executives of the NHS and Councils involved in that partnership. Progress on workforce and structural changes will be regularly reported to the full Council/Corporate Management Team/Area Partnership Forums and SIB as appropriate Job Description & Person Specification / Job Role Evaluations A Job Description & Person Specification/Role Profile will be developed for each post for evaluation in line with the Job Evaluation schemes within the respective organisations The salary for Local Authority Chief Officer posts will assimilate to the most relevant Chief Officer spinal column point.

11 Eligible Pool Identification The responsible organisations will determine whether a restricted eligible pool exists for the senior joint appointment. This will be done in consultation as appropriate (Trade Union/Local Partnership) Eligible pools should only comprise of individuals whose post is directly affected by the creation of the new senior joint post within the revised structure that is affected substantially enough to impact the viability of their current substantive role In the event that agreement of eligible pools cannot be reached the matter should be referred to the Chief Executives for a decision If an eligible candidate pool exists, the Director, together with relevant HR representative and Trade Union Representative if requested, will meet on a individual basis with the relevant employees to advise them of the possible employment options which could include: o Which, if any, eligible pools they are part of o The process for selection o The employment potential outcomes, depending on each organisations policies, procedures and practices. Given the complexities of the Partnership, all individuals identified as eligible will require to take part in a recruitment selection process, which may be competitive Due consideration should be taken of any other processes for senior joint appointments running in parallel timing within other partnerships, of which an individual may also be within the eligible pool. However, the progression and subsequent recruitment and selection of candidates should not be unduly delayed All relevant staff should be consulted timeously and where possible simultaneously within the partnership to support effective communications Recruitment & Selection A recruitment process will be agreed that should, where possible, be adopted for the appointment of these Joint Appointments Following the recruitment process the successful candidate will be notified as appropriate by the chairperson or representative of the outcome The Director and HR representative will discuss the options which have been shared at the previous individual meetings with unsuccessful candidates If no eligible pool exists or no one is appointed from the eligible pool, the following steps should be followed: o Review the redeployment register to identify any potential candidates (NHS) o If no-one is on the redeployment register then move to advertising and recruitment process. Appointments When the preferred candidate has been identified, appropriate pre employment checks and references will be sought by the relevant organisation: o If the candidate is currently employed by either NHS or LA they have the choice to which employer and subsequent terms and conditions they wish to be employed by. o Similarly if they are new to NHS or LA then they will be able to choose their employer and subsequent terms and conditions. That employer will be responsible for the processing of the relevant documents.

12 Certain posts will require to be attached to a specific employer for registration purposes e.g. a nursing post would be NHS and the Chief Social Work Officer would be Local Authority A robust and relevant induction will be necessary across the partnership. This should be led by the Director for Health and Social Care with support from HR. Local HR will ensure that the relevant contractual arrangements are put in place Appropriate Performance Management processes should be in place led by the Director. Review The Guiding Principles and Agreed Process will be reviewed no later than after the shadow year. 3 April 2014

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