Health and social care integration: finance guidance

Section B Delegation to an Integration Joint Board

1 Introduction

1.0.1 Under this model of integration, the Health Board and Local Authority delegate functions and resources to the Integration Joint Board.

1.1 Integration scheme, Strategic Plan, Annual Financial Statement and Annual Performance Report

1.1.1 The Integration Scheme sets out the detail of the integration arrangement, as agreed by the Local Authority and Health Board and submitted to Scottish Ministers for approval (Section 7(1)). Regulations require that it covers a number of finance related matters:

• Functions which are to be delegated to the Integration Joint Board by the Health Board and Local Authority;
• The method for the determination of the resources to be made available by the Local Authority and Health Board to the Integration Joint Board for the delegated functions;
• Reporting arrangements between the Integration Joint Board, Health Board and Local Authority; and
• Arrangements for providing financial services to the Integration Joint Board;
• Financial management arrangements for variances and redetermination of payments and amounts set aside; and
• Arrangements for the use of capital assets in relation to the integration functions.

1.1.2 It is recommended that the Integration Scheme should also define those services which are not delegated to the Integration Joint Board but are managed by the Chief Officer on behalf on the partner Local Authority and Health Board.

1.1.3 The Integration Joint Board will lead the preparation of the Strategic Plan with other stakeholders, in line with the principles and duties set out in the legislation (Sections 29-39); the Strategic Plan will describe the capacity required by the partnership population along the spectrum of care and the resources available to deliver the outcomes.

1.1.4 The Integration Joint Board will publish an Annual Financial Statement (Section 39) which will set out the amount that will be spent in each year of the strategic plan. Guidance on the content of the Annual Financial Statement is included the Statutory Guidance for Strategic Planning.

1.1.5 The Integration Joint Board will publish an Annual Performance Report (Section 42) within four months of the year end with an assessment of its performance in planning and carrying out the integration functions. Regulations require that it contains financial information for the reporting year on the following:

• Service type and the balance of care;
• Key care groups;
• Localities; and
• Assessment of performance in achieving best value.

1.1.6 Statutory Guidance on the content of the Annual Performance Report will be published by Scottish Government separately.

1.2 Chief Officer

1.2.1 The Chief Officer will be the accountable officer of the Integration Joint Board in all matters except finance. The Integration Joint Board must make arrangements for the proper administration of its financial affairs and appoint an officer with this responsibility, (the Integration Joint Board financial officer) (Section 13(a)). The Chief Officer may be appointed to this role if the joint board deems it appropriate. (See Section 1.4.2 for financial accountability).

1.2.2 It is recommended that in appointing a financial officer the Integration Joint Board has regard to the CIPFA guide on The Role of the Chief Financial Officer in Local Government^[8].

1.2.3 The Chief Officer will also hold an operational role in the Health Board and Local Authority, for the management of the operational delivery of the services as directed by the Integration Joint Board. This will involve a delegation of budgets from the Health Boards and Local Authorities following their established procedures. She/he should receive support and advice in this role from the Finance Director in the Health Board and Section 95 Officer in the Local Authority (See section 2.1).

1.3 Financial model

1.3.0.1 The Health Board and Local Authority will delegate functions (Section 1) and make payments to the Integration Joint Board in respect of the delegated functions (Section 14); and the Health Board will also set aside amounts in respect of large hospitals for use by the Integration Joint Board. The Integration Joint Board will produce the Strategic Plan for the use of these resources and give direction and make payment where relevant (Sections 26 and 27) to the Health Board and Local Authority for delivery of the services in line with the Strategic Plan.

1.3.0.2 The legislation uses the term payment for the transfer of resources by the partner Health Board and Local Authority to the Integration Joint Board and for the allocation back from the Integration Joint Board to the Health Board and Local Authority for operational delivery. This term does not necessitate cash transactions and it is recommended that the majority of the accounting for these be via book entries within the ledgers of the Health Board and Local Authority, one of which should host the accounts of the Integration Joint Board.

1.3.1 Resources within the scope of the Strategic Plan

1.3.1.1 These will comprise:

• The payment made to the Integration Joint Board by the Local Authority for delegated adult social care services (A);
• The payment made to the Integration Joint Board by the Health Board for delegated primary and community healthcare services and for those delegated hospital services which will be managed by the Chief Officer (B); and
• The amount set aside by the Health Board for delegated services provided in large hospitals for the population of the Integration Joint Board (C).

1.3.1.2 The Integrated Budget comprises of parts (A) and (B). The minimum scope of services (Section 1 (7) and (8)) to be included in each of (A), (B) and (C) is set out in regulations. The Local Authority and Health Board may include other services, beyond the minimum requirement, within the scope of the plan. The legislation takes powers for Ministers to set this out in regulations and also to specify those services that may not be delegated to the Integration Joint Board (Section 1 (10) and (11)).

1.3.2 Resources outside the scope of the Strategic Plan

1.3.2.1 In addition to the services within scope of the Strategic Plan and managed by the Chief Officer, the Local Authority and Health Board may request that the Chief Officer manage services that are outside of the scope of the Strategic Plan.

E.g. Children's community health services, children's social work services, or other ex-Community Health Partnership (CHP) services that fall outside the scope of the plan.

1.3.2.2 The resource model for delegation to an Integration Joint Board is shown in figure 1 below. In this example the resources within scope of the Strategic Plan total £150m, comprising £110m in the Integrated Budget allocated to the Integration Joint Board and £40m notional budget for large hospital services managed by the Health Board.

Figure 1: Delegation to an Integration Joint Board.

1.4 Financial governance

1.4.1 Statutory reporting

1.4.1.1 The Integration Joint Board will be required to produce its own statutory accounts as a body under Section 106 of the Local Government (Scotland) Act 1973. (Section 13) Legislation specifies the minimum reporting requirements for the annual accounts (Section 12 of the Local Government Act in Scotland Act 2003 and regulations under Section 105 of the Local Government Scotland Act 1973).

1.4.1.2 The Local Authority and Health Board will be required to include additional disclosures and group accounts as part of their financial statements which reflect their relationship with the Integration Joint Board.

1.4.2 Financial accountability

1.4.2.1 The Integration Joint Board must appoint an officer to be responsible for the administration of its financial affairs, referred to in this guidance as the Integration Joint Board financial officer. It is recommended that in appointing the financial officer the Integration Joint Board has regard to the CIPFA guidance on the role of the Chief Financial Officer in Local Government^[9].

1.4.2.2 The legislation allows for the Chief Officer to be appointed to this post if the Integration Joint Board deems it appropriate. In the event that the Chief Officer is appointed as the Integration Joint Board financial officer but does not hold a professional finance qualification, it is recommended that arrangements are put in place to provide him/her and the Integration Joint Board with financial advice from a suitably qualified person. For example, from the Director of Finance of the Health Board and the Section 95 Officer in the Local Authority (or their delegates). This is a matter for local determination and the arrangement will be included in the annual governance statement. Where the role is not fulfilled by the Chief Officer, it is recommended that it should be carried out by a joint appointment from the senior finance team of either the Health Board or Local Authority.

1.4.2.3 The Health Board and Local Authority may make use of non-current assets, owned or otherwise, to deliver the services in scope of the Strategic Plan. Ownership of the assets and the associated liabilities will be unchanged and remain with the partner Local Authority and Health Board.

1.4.3 Risk management

1.4.3.1 The Integration Joint Board should establish a system of risk management arrangements for the functions delegated to it. The operational delivery of services by the Local Authority and Health Board, as directed by the Integration Joint Board, will be subject to their respective governance and risk management arrangements.