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Council / Convener unhappy over level of SIC input into post-Covid health and social care plan

SIC convener Malcolm BellSIC convener Malcolm Bell.

SHETLAND Islands Council convener Malcolm Bell has voiced concern that a plan setting out how health and social care services will be restored in the wake of Covid-19 has not been presented to a joint forum featuring NHS Shetland and the local authority. 

The plan, setting out how the local health service aims to manage a backlog of planned care and ensure unmet demand is managed, was outlined to NHS Shetland board members on Tuesday.

The details of the plan can be read online.

Bell said was “disappointed” the plan had not gone before Shetland’s integration joint board (IJB), which brings together the council and NHS Shetland to oversee health and social care throughout the islands.

It is the latest manifestation of tension between the local authority and the health board.

The two organisations have clashed publicly over island councils’ approach to the Scottish Government regarding the possibility of a localised approach to Covid-19 guidelines.

Public health principal Elizabeth Robinson said NHS Shetland had a meeting that was on the whole “positive” with the Scottish Government to discuss the plan a couple of weeks ago, with the government suggesting a few tweaks.

She added the health board was now waiting for final feedback on the funding requested to enact the plan, which was first written in July.

Robinson likened remobilising services to a “dance” against a backdrop of shifting guidance, with the health board needing to take advantage of the calmer moments as well as responding to any outbreaks.

NHS Shetland board member Bell, however, questioned why the plan had not gone in front of the IJB. He said “much of what’s in this plan is core IJB business”. 

Some of it relates to council operated services, such as the Edward Thomason & Taing Support Services care centre.

Dickson said the plan had to be submitted to the requirements of Scottish Government and NHS Scotland. He was not aware of any change in the directions given out by the IJB – although he was “really open” if there was a desire to adjust them.

 IJB chief officer Brian Chittick explained that he gave a presentation to members of the IJB in September on the recovery plans.

Bell, however, referred to guidance from the Scottish Government released in May on the framework for remobilising health services. It says that “plans should be constructed with local partners”. 

After Bell said he was “disappointed” the plan had not come in front of the Shetland IJB, Dickson said he took issue with his view. He said Chittick and Robinson had worked “really hard” to engage partners. 

Dickson suggested that just because it had not gone through the “quite bureaucratic process” of being formally approved by the IJB it did not mean there had been no engagement.

Robinson said that a lack of time to put together the plan had left the health board in an “impossible situation”, adding there could be scope to look at “doing this better in the future”.

Bell said he understood the time constraints, but took exception to suggestions that the IJB is “bureaucratic”.

NHS Shetland board member Jane Haswell, who also sits on the IJB, said the joint board had received a detailed presentation from Chittick on the recovery of services. “The IJB has had sight of this,” she said.

Chittick explained that his presentation was given prior to NHS Shetland’s discussions with the Scottish Government, hence why the plan did not go to the IJB at that stage.

He added that the plan had been due to go to an IJB meeting this Friday (9 October) before it was postponed.

NHS finance director Colin Marsland added that the SIC’s finance department had been involved in discussions regarding the plan’s funding costs. 

NHS Shetland chairman Gary Robinson ended the discussion by saying the board should write to the IJB’s chairwoman, SIC councillor Emma Macdonald.