Agenda item

A presentation will be provided as part of this item on the risks associated with the Integration Transformation Fund.

The Committee considered a report of the Director of Corporate Resources, the purpose of which was to provide an overview of key risk areas and the measures being taken to address them.  The report also provided an update on the Internal Audit Review of the revised Risk Management Policy Statement and highlighted key information on anti-fraud initiatives.  A copy of the report is filed with these minutes.

The Committee also received a presentation on the ‘Better Care Fund’ risk area of the Corporate Risk Register.  A copy of the presentation slides is filed with these minutes.

Risk Register – risk relating to the transfer of nine elderly persons homes

(i)            Some members questioned the expectation noted in the register (page 59 of the report) that this risk would move to a medium rating and suggested that there were still uncertainties around whether or not the outstanding deferred payment would be received by the deadline of 31 March.  It was suggested that this risk should continue to be rated high until such time as the balance had been received; 

(ii)          The Committee noted that the expected risk rating had been based on the fact that the deadline for payment had not yet been reached, that payment was expected and that the County Council had not incurred any financial loss and had continued to receive regular interest payments; 

(iii)         A report had been presented to the Cabinet on 4 February 2014 outlining the up to date position.  Leicestershire County Care Limited (LCCL) was in the process of securing the finance it required to repay the balance outstanding and payment was still expected within the agreed timescale;

(iv)         To mitigate against the risks to the County Council if payment was delayed, various options had been presented to the Cabinet on 4 February 2014 for consideration and these would be pursued if necessary;

(v)          The Committee noted that ultimately the County Council had a legal charge secured against the homes should LCCL not meet the arrangements for repayment.  However, some members questioned how viable this option would be in practice.  The Committee was advised that the needs of residents would always be considered and that this was one of a number of actions which could be taken if necessary; 

(vi)         The Committee agreed that further consideration of the level of risk relating to this issue should be deferred to its next meeting in May, which would be after the deadline for payment had passed.

Presentation - Better Care Fund (BCF)

(vii)        The introduction of the NHS 111 service would be an important part of the development of a new integrated health and care system nationally.  It supported demand management by signposting people to the right service for their needs and provided information and advice to support self care.  It would be necessary to link the new community services offered in Leicestershire, as a result of the developments in the BCF, to the menu of services/information held by the NHS 111 service so that its information kept pace with new local developments;

(viii)      A draft BCF Plan had been prepared and would shortly be presented to the Health and Wellbeing Board for consideration.   Further work was being undertaken to identify the impact of the Plan on outcomes and performance metrics, including measures required both nationally and locally;

(ix)         The BCF Plan proposed a number of activities to address the rising trend in emergency admissions.  The trajectory of improvement proposed in the BCF Plan was to reduce these numbers locally by 500 when comparing a period of six months in 2013 with the same period in 2014/15.  A reduction in the number of bed days associated with delayed discharges had also been proposed.  These metrics would be tested and subjected to a challenge process before the final submission of the Plan in April.  It was expected that the scale and pace of the metrics could be further challenged, as there would be a need to make a significant impact on reducing acute hospital activity over the next two years.

(x)          As part of the development process an assessment of all projects aimed at supporting people leaving hospital, including those provided by the County Council and support services such as adaptation grants, would be undertaken.  Consideration would be given as to how these could be brought together to provide an overall improved package of care.  Equality and other relevant impact assessments would be undertaken to ensure there was a clear understanding of how various groups might be affected.

RESOLVED:

(a)  That the status of the strategic risks facing the Council be noted and that the updated Corporate Risk Register be approved;

(b)  That the initiative adopted to improve the Council’s acknowledgement, prevention and pursuit of fraud be supported;

(c)  That, in the light of concerns now raised by the Committee, issues relating to the risks to the County Council surrounding arrangements in respect of the transfer of nine Elderly Persons Homes in September 2012, be further considered at the next meeting of the Committee;

(d)  That officers be requested to provide a presentation at the next meeting of the Committee on the risks associated with the delivery of savings and efficiencies through Service Redesign/Transformation as required in the MTFS.