A REVIEW of day services in Argyll and Bute is set to return to the agenda in two weeks’ time after health and social care chiefs agreed to defer a decision.
A report by the area’s health and social care partnership (HSCP) to its integration joint board (IJB) recommended a programme to make day services more sustainable.
A deputy leader of Argyll and Bute Council then moved a motion asking the IJB to call on the Scottish Government to work with the HSCP and council on public sector reform.
But an amendment asked for a two-week deferral to allow for full consideration of the motion at a follow-up meeting, and won on a roll call vote.
The discussion took place at a meeting of the IJB in Oban on Wednesday, September 16. The follow-up meeting will be held remotely on a date to be confirmed.
A report in advance of the meeting said: “The review identified that the current model is not sufficiently resilient, sustainable or able to demonstrate value for money. Access remains narrow, pathways and the service offer require further definition, delivery is inconsistent between sites and vulnerable to interruption, utilisation is variable, and performance information is not strong enough to evidence best value.
“The option we would seek to recommend to the IJB based on the content of the report is amended option two – a structured redesign programme that provides outcomes for older adults and their carers that are currently delivered through day services but as a more sustainable model as part of the wider social care system.
“This should consider utilisation, access, measurable outcomes and integration with wider health and social care pathways, including commissioned, community and partnership provision where this better meets local need.
“This would require a time limited implementation plan overseen by the IJB, will require employer process and potential for both internal and external commissioning of services. In parallel all attendees would require to have an up-to-date assessment of need to determine any potential alternative care and respite requirements that may arise.”
Councillor Ross Moreland (Liberal Democrat, Dunoon) moved a motion asking: “The IJB notes that the day services review demonstrates the need for sustainable, integrated and locally responsive services, reflecting the objectives of public sector reform in Argyll and Bute.
“The board considers that the proposed redesign of day services highlights the importance of ensuring that future reforms support local decision-making and improved outcomes for older adults and unpaid carers across the area.
“That the integration joint board notes the Scottish Government’s ongoing programme of public sector reform and the potential impact on health and social care service and move for option two with these possible changes in mind.
“The IJB recognises that Argyll and Bute has unique geographical and demographic challenges, including its island and rural communities, dispersed population, and the additional costs and complexities associated with delivering services across a large geographic area.
“The IJB further notes discussions regarding future models of public service delivery, including the potential for a single authority model for health and social care, and recognises that such an approach may offer opportunities for improved integration, streamlined decision-making, reduc bureaucracy and costs.
“The IJB therefore calls on the Scottish Government to work collaboratively with Argyll and Bute HSCP and Argyll and Bute Council in the development and implementation of public sector reform.”
HSCP chief officer Evan Beswick then said: “We are at 5pm at the end of this meeting and I am mindful there is a lot in this motion, and we have not had any time to discuss it.
“I wonder if I might suggest we need more time to discuss this. It seems not entirely related to the paper to which it refers and has important points that we need to understand.”
NHS Highland non-executive director Karen Leach said: “I think there are various points made that we have had in this forum, but I am struggling to see the purpose of this amendment, so I would appreciate further time to discuss this.
“I would like to propose an amendment that we defer the item to allow consideration at a special meeting in two weeks’ time.”
Ms Leach’s amendment asked: “To defer the item to allow for full consideration at a special meeting in two weeks’ time in consultation with the chair and vice-chair regarding date setting.”
Councillor Moreland responded: “I do not think two weeks is unreasonable, but would make the point that my motion does deal with the paper, and two weeks is one sixth of the time that the first minister is planning to engage [on public sector reform]. The clock is already running.”
After a roll call vote, the amendment moved by Ms Leach prevailed by six votes to two. Councillor Dougie McFadzean (SNP, Kintyre and the Islands), chairing the meeting in place of chair Graham Bell, said that the follow-up meeting would be fully remote.
