Aberdeenshire Integration Joint Board meeting
The Aberdeenshire Integration Joint Board (IJB), which oversees the Aberdeenshire Health & Social Care Partnership (AHSCP) met yesterday (Wed 28th May).
In February at its indicative budget setting meeting the IJB agreed to the review of several services with required budget savings in order to reduce a budget gap of £36.882million.
To bring the budget back into line the AHSCP must make £15.788million in savings and efficiencies this year and has agreed to move to a full cost recovery model for chargeable services in order to raise a further £3.939million. £17.155million is being underwritten by the IJB funding partners, NHS Grampian and Aberdeenshire Council as part of a financial recovery plan.
The IJB was presented with papers outlining changes to Day Service provision for Adults with Learning Disabilities, removal of the current Assisted Transport provision for social work, rationalisation of older adult activity hubs in North Aberdeenshire, and a new strategic framework for the delivery of in-house Care at Home and ARCH services.
Throughout the meeting there were a number of people who spoke powerfully to the potential impact that the changes proposed across a range of papers may have on them and IJB members were urged to look at the impact of changes as a whole and not in isolation.
Chair of the Aberdeenshire IJB, John Tomlinson, said: “We have heard several speakers describe the fears they have about how the decisions we have made today may impact on them and their loved ones. None of us take this responsibility lightly, there has been some sober and reflective discussions in the room today and we are assured that officers will proceed with sensitivity and compassion as we make the changes we must.
“Unfortunately, the fundamental fact is that we must make savings now, if we do not, we risk the financial stability of our funding partners and the knock-on impacts that would have on wider public services across Aberdeenshire.
“The IJB must stabilise its budget by operating within the funding we have available to us. This means we must urgently close the gap between how much our services cost and the actual money we have available to deliver them. The IJB agreed, at our budget setting meeting, over £12million in wider savings and today we have made decisions which will help close the remaining gap in our budget for this year and for the years to come.”
Vice Chair of the IJB, Cllr Anne Stirling, said: “The financial viability of the Aberdeenshire IJB and AHSCP is at risk just now and we must do all that we can to bring our budget back into line.
“Across health and social care, we are facing a perfect storm of ever-increasing demand across all of our services as our population ages and needs become increasingly complex, along with high rates of inflation which have impacted across the board.
“Our budget for delivering community health and social care services this year is over £422million and it is the job of this board to make difficult decisions and provide strategic direction to officers to ensure that we make our services sustainable into the future.”
Leigh Jolly, Interim Chief Officer for the Aberdeenshire Health & Social Care Partnership, said: “I would like to acknowledge the concerns that we have heard today about the changes we will be making, and I can assure people that we will work alongside every individual effected by the change to support any transition to be as smooth as it can be and to do all we can to mitigate any negative impacts.
“I know that this is also a very concerning time for our staff some of whom will be at risk of redundancy as a result of the changes agreed today. I understand that anything I say will be of cold comfort to those at risk however I can assure all our staff that we will proceed with full transparency and sensitivity over the coming weeks and months and support every individual affected to understand their rights and access support as required.”
Full papers and a recording of the meeting is available here: https://aberdeenshire.moderngov.co.uk/ieListDocuments.aspx?CId=166&MId=8041&Ver=4
Below is an outline of some of the papers which were agreed:
Item 10: In-House Care at Home Service Redesign
In-line with the AHSCP’s strategic priority of intervention and early intervention, the new service priorities will be, where appropriate, to focus on delivering time limited reablement packages to support people to be more independent for longer.
The out of hours ARCH service would continue prioritising end of life care, community alarm response and uninjured fallers. Across Aberdeenshire nearly 40,000 hours of homecare are delivered every week – over 85% of which are delivered by independent providers.
Recommendations:
1.1 Agree the strategic direction for the In-house Home Care and Aberdeenshire Responders Care at Home Service (ARCH) to deliver a reablement service, end of life care and a streamlined responder service;
1.2 Agree to the redesign of the In-house Care at Home Service to become a specialist service to deliver short-term, intensive reablement support and for officers to commence call offs from the existing Support at Home Framework for care packages that do not meet this service priority;
1.3 Agree to integrate the ARCH and Home Care Service daytime provision as one service under one management structure;
1.4 Agree to retain the ARCH overnight service (10pm to 7am) until the impact of the reduced provision introduced in mid-March 2025 can be evaluated with an update report to IJB committee on the 3rd September 2025;
1.5 Agree to cease the planned care being delivered by ARCH and deliver unplanned care with the following priorities: end of life care, community alarm response and uninjured fallers;
1.6 Agree to cease providing an ARCH response to internal and registered social landlord sheltered housing complexes through their own call systems.
Cllr Anne Stirling, Vice Chair of the IJB, raised an amendment which agrees all of the recommendations as they are and requires Officers to report back to the IJB on any exceptions on the implementation of recommendation 1.2 should there be any. This was agreed by a margin of 7 to 2. All of the other recommendations were agreed
The discussion in the meeting included questions from our Unison member Inez Kirk who asked how we monitor independent providers and ensure that they pay the Real Living Wage. Janine Howie, Partnership Manager and lead for this work assured the IJB that there are robust contract monitoring processes are in place.
The implementation of the proposals contained in this paper will be an iterative process with reports coming back to the IJB to highlight any issues etc. TUPE consideration requirements will be met where applicable.
The next stage in the process would be to look at the care packages which would not meet the criteria for the new service priorities and look at the feasibility of re-commissioning those packages. This would then mean we would be able to better understand the impact on our staff. Voluntary severance is also being considered.
Members also raised concerns around the capacity of independent providers to deliver the re-commissioned care packages. Janine answered that there will be greater clarity and ability for officers to continue with the changes now that the IJB has made a decision. However, there has been a positive response from providers so far who already deliver the majority of the homecare across Aberdeenshire.
Item 11: Activity Hubs Review (North)
There are currently 3 Older Adult Activity Hubs in North Aberdeenshire delivered in our Very Sheltered Housing Complexes at Doocot View in Banff, Abbey Court in Mintlaw and Jarvis Court in Fraserburgh. This review looked at the service model for the delivery of Day Services for Older adults.
Recommendations:
1.1 Agree to reduce and consolidate the day activity (older adult day care) sessions per week across three very sheltered housing sites in North Aberdeenshire from the current 10 sessions provided to 5 sessions.
1.2 Agree to a strategic review of the provision of older adult day care for older people across Aberdeenshire to be completed by 31st December 2025. All of the recommendations were agreed
Item 12: Review of Older People’s Residential Care Homes
Following an Options Appraisal the IJB was recommended not to proceed with a planned Care Home or Very Sheltered Housing Complex in 2025/26. This will mean that the £826,000 in projected savings will need to be identified and a paper will be brought back to the July IJB meeting to highlight where those savings will be found.
Recommendations:
1.1 Acknowledge the decision taken by the IJB at its meeting on 19 February 2025 for officers to undertake a review of Older People’s Residential Care Homes and Very Sheltered Housing across Aberdeenshire – to include the review and rationalisation of in-house care home provision where indicative savings had been identified.
1.2 Consider the outcomes of the subsequent options appraisal exercise undertaken by the Aberdeenshire HSCP.
1.3 Agree there should be no planned care home closures in this financial year (2025/26) due to the risks identified.
1.4 Agree to the acceleration of income maximisation measures with appropriate policy decisions being brought back to the IJB for approval to address and ensure the financial viability of the HSCP’s in-house care homes and very sheltered housing (VSH) complexes.
1.5 Acknowledge the work being undertaken as part of the ongoing workstream to drive improvement across all in-house services and to ensure a lean and optimally efficient operating model.
1.6 Agree the proposal to conclude work on agreeing the strategic direction and future sustainable model for care home and VSH provision across Aberdeenshire supported by a commissioning strategy.
1.7 Agree that a progress report is presented at the IJB’s meeting on 5th July 2025.
The paper was deferred until the July meeting of the IJB
Item 13: Review of Assisted Transport Policy for Adult Social Work Services
The review of the Assisted Transport Policy for Adult Social Work Services is required to achieve over £800,000 in savings in 2025/26. The paper outlines the local authority policies, national legislation and strategic frameworks in place which underpin the current provision of assisted transport. There is no legal requirement to deliver the service currently in place.
Recommendations:
1.1 Acknowledge the work of the review into Aberdeenshire Health and Social Care Partnership (HSCP) Assisted Transport Policy for Adult Social Work Services.
1.2 Agree for Aberdeenshire HSCP to cease the provision of assisted social care transport (unless required by statute) following recommendations by the Short Life Working Group (SLWG).
1.3 Approve the revised policy for Assisted Social Care Transport, as detailed in appendix 2. This will mean that of 218 service users currently receiving assisted transport support, 176 service users who are currently receiving mobility allowance and transport provision, will no longer be eligible for in house transport services and it will result in less than 45 people possibly receiving some form of support or assistance presenting with transportation issues and no access to mobility allowances to access their services.
There were two people who spoke to the potential impacts that a cessation of the Assisted Transport programme could have on those who it supports to attend social care services. Discussion in the room focused on the rurality of Aberdeenshire and how that is an additional element when looking at the provision of social care transport.
All of the recommendations were agreed.
Item 14: Review and rationalisation of in-house Learning Disability Day Service provision
This paper outlines the findings of the Review of in-house Learning Disability Day Services and the implementation of a standard operating model across Aberdeenshire based on the roll-out of the Aberdeenshire Learning Disability Strategy ‘Be All You Can Be’
The paper also includes information on a future staffing model which will mean a reduction in headcount.
Recommendations:
1.1 Acknowledge that to achieve consistency of service across Aberdeenshire the Learning Disability Strategy ‘Be all you can be’, fully supported by IJB in March 2020 is being implemented across Aberdeenshire following successful implementation in the South.
1.2 Note that the IJB, at its meeting on 19 February 2025, approved a review of in-house learning disability day services specifically all building base usage and the staffing model moving forward.
1.3 Consider the outcomes of the review as set out in this report.
1.4 Direct Aberdeenshire Council to implement a hub and spoke model for the delivery of services because of the review as follows:
North:
In-house Learning Disability Day Services at Robertson Road Centre, Fraserburgh would be retained as the main hub in North, with Banff Day Services and Buchan Day Opportunities (Suite H & E only) as satellite bases.
Central:
In-house Learning Disability Day Services at Inverurie Day Centre, would be retained as the main hub in the Central area, with Ellon Resource Centre and Pitscurry, Pitcaple as satellite bases.
1.5 Direct Aberdeenshire Council to cease the following service provision:
North:
• BEAT, 16 Old Gamrie Road, Macduff,
• Can Do Recycling and Shop, Unit 1 and Unit D, Anderson Place, Fraserburgh,
• Woodwork Project at Aden Country Park, Mintlaw, Peterhead,
• Buchan Day Opportunities, Crimond Medical and Community Hub (Suite K), Logie Avenue West, Crimond,
• Connecting the Broch
Central:
• Can Do, 11, Castle Street, Ellon, AB41 9RF
• Benchmark, 1 Castle Street, Ellon, AB41 9RF
• The Buzzard Café, CO/O The Pitscurry Project, Inverurie, AB51 5DY
Six people spoke movingly to the impacts that the proposed changes and Leigh Jolly, Interim Chief Officer for the IJB, promised a reset in relationships and that Officers of the AHSCP and families would work together to move forward.
All the recommendations were agreed.
Link to a recent Audit Scotland Report which outlines the financial challenges in health & social care across Scotland: https://audit.scot/publications/integration-joint-boards-finance-and-performance-2024