Integration Joint Board: roles, responsibilities and membership

Section 2: Membership of the Integration Joint Board

2.1 Minimum Membership

The Public Bodies (Joint Working) (Membership and Procedures of Integration Joint Boards) (Scotland) Order 2014 ("the Order") sets out requirements about the membership of an Integration Joint Board. This includes minimum required membership, and provision for additional members to be appointed.

The Integration Joint Board is created as a new legal entity that binds the Health Board and the Local Authority together in a joint arrangement. The membership of an Integration Joint Board reflects equal participation by the Health Board and Local Authority to ensure that there is joint decision making and accountability.

The Local Authority and the Health Board will set out the number of representatives that will sit on the Integration Joint Board within their integration scheme. The Order requires that the Local Authority and Health Board put forward a minimum of three nominees each. This number may be increased by local agreement, but the same number must be nominated by each party. Local Authorities can insist on nominating a maximum of 10% of their full number of Councillors. The Health Board and Local Authority may also agree that they will each nominate a larger number than this.

The Local Authority will nominate Councillors to sit on the Integration Joint Board.

The Health Board will nominate non-executive directors to sit on an Integration Joint Board. Where the Health Board is unable to fill all their places with non-executive directors, they can then nominate other members of the Health Board.

The Integration Joint Board will make decisions about how health and social care services are planned and delivered for the communities within their areas. To do this effectively, they will require professional advice, for example, to ensure that the decisions reflect sound clinical practice. It is also essential that Integration Joint Boards include key stakeholders within the decision making processes to utilise their advice and experience.

To ensure this, the Order sets out a minimum membership, but allows local flexibility to add additional nominations as Integration Joint Boards see fit. In addition to Health Board and Local Authority representatives, the Integration Joint Board membership must also include:

• The Chief Social Work Officer of the constituent Local Authority
• A General Practitioner representative, appointed by the Health Board
• A Secondary Medical care Practitioner representative, employed by the Health Board
• A Nurse representative, employed by the Health Board
• A staff-side representative
• A third sector representative
• A carer representative
• A service user representative
• The Chief Officer of the Integration Joint Board
• The Section 95 Officer of the Integration Joint Board

The Chief Social Work Officer will be appointed by the Local Authority and the health professionals will be appointed by the Health Board because of the role they fulfil. The Chief Officer must be appointed by the Integration Joint Board and will provide a single point of accountability for integrated health and social care services. The Integration Joint Board must also appoint the Section 95 Officer who will be the responsible officer for the financial arrangements of the Integration Joint Board

The ways in which the members of the Integration Joint Board are to be identified and appointed to the Integration Joint Board will differ. The Integration Joint Board will co-opt the staff-side, third sector, carer and service user representative, and this should be done as soon as practicable once the Integration Joint Board is established. How the Integration Joint Board approaches the appointment of the staff-side, third sector, carer and service user representative members will be dependent on local circumstances, for example, through existing carers networks or the organisations operating within the area of the Integration Joint Board, therefore section 2.4 sets out principles that should be implemented in the identification of members.

Whilst there is a required minimum membership for inclusion on the Integration Joint Board, there is also local flexibility for the Integration Joint Board to add additional members. The Independent Sector for example provide a significant proportion of social care services and will therefore play a key role in the successful delivery of integrated services in local areas. As part of their strategic planning responsibilities, Integration Joint Boards should consider their membership cohorts and seek appropriate additional representation as suggested by local priorities. Integration Joint Boards might also seek additional membership to reflect delegation of functions outside the minimum scope, for example additional professional advice.

If an Integration Joint Board is established by more than one Local Authority, the Order makes specific provision for how the minimum membership is to be determined.

2.2 Good Practice in the identification and appointment of members of Professional and Stakeholder members

The Order sets out the minimum required membership. All Integration Joint Board members have equal responsibility as Board members and the reference made between professional members and stakeholder members in the following section only reflects the difference in the routes of appointment.

The Order also makes provision for the Integration Joint Board to appoint additional professional and/or stakeholder members, as required.

To ensure that members are able to successfully fulfil the roles they are appointed to, sections 2.3 and 2.4 set out principles that should be implemented in the identification of members.

2.3 Professional Membership

The Order requires a minimum professional membership on the Integration Joint Board as follows:

• Appointment of a GP
• Appointment of a Nurse
• Appointment of a Secondary Care representative
• The Chief Officer of the Integration Joint Board
• The Section 95 Officer of the Integration Joint Board
• The Chief Social Work Officer of the constituent Local Authority

With the exceptions of the Chief Officer, the Section 95 Officer and Chief Social Work Officer, the Order provides some flexibility in the appointment of professional members. However, due to the particular skills and experience required, and the strategic nature of the professional roles on the Integration Joint Board, the Health Board, Local Authority and the Integration Joint Board should follow the principles below to ensure they identify the appropriate members of professional staff to fill these posts:

• The professional members appointed will bring professional experience and knowledge to inform the Integration Joint Board decision making in terms of planning, operational delivery and the effectiveness of major reforms. This advice will ensure the Integration Joint Board can fully take account of safety and quality of care matters. As such, the appointed person must be able to demonstrate the appropriate experience, skills and competencies to fulfil this role. The appointed member must demonstrate their ability to work at a senior level and have experience of operating at a strategic level;
• Professional members should have a named, appointed deputy, able to demonstrate a similar level of skill and experience as the substantive appointment. Deputies should be expected to attend only where absolutely necessary to ensure continuity of advice from the professional.
• The Health Board should ensure the appointed professional members have defined roles that are clearly set out, and held locally. The Health Board and/or Local Authority must ensure that they have time, resource and support to fulfil their responsibilities to the Integration Joint Board for the full term of their appointment.
• As effective strategic planning is key, the Health Board and Local Authority must ensure that the appointed professional members are given specific training and support to contribute effectively to the Integration Joint Board, where such training is required.

The above principles should also be considered when the Integration Joint Board opts to appoint additional professional members. However, in this case the application of each principle will depend on the nature and basis on which these additional members are appointed.

2.4 Appointment of Stakeholder members

In addition to the professional membership, the Order also requires stakeholder members be appointed to the Integration Joint Board as follows:

• A staff side member
• A third sector member
• A carer member
• A service user member

The ways in which stakeholder members will be identified and appointed to these positions on the Integration Joint Board will vary due to the local circumstances of each Integration Joint Board, such as type and number of the representative groups working within their area. Although there will not be a uniform approach in appointment of the stakeholder members, it is important that they are able to appropriately fulfil their roles. The Integration Joint Board should follow the principles set out below:

• Stakeholder members will reflect the views of the groups they represent on the Integration Joint Board; naturally the individuals that comprise these stakeholder groups will be diverse. As such, the appointed person must be able to demonstrate the appropriate experience and skill to reflect the breadth and diversity of views and situations of the individuals or groups that they represent.
• The Integration Joint Board should ensure the appointed member has the resources and support to fulfil their responsibilities to the Integration Joint Board for the full term of their appointment.
• As effective strategic planning is key, the Integration Joint Board must ensure that the appointed stakeholder members are given specific training and support to contribute effectively to the Integration Joint Board, where such training is required.

As with professional members, these principles should also be considered when the Integration Joint Board opts to appoint any additional stakeholder members. The implementation of each principle will depend on the nature and basis on which these additional members are appointed.

2.5 Induction of Members

As well as their collective roles in carrying out the responsibilities of the Integration Joint Board, members will have individual roles to carry out to ensure that integrated health and social services are planned and delivered to improve outcomes for the communities they serve. In doing so, Integration Joint Board members must ensure that this is carried out effectively and in line with the integration delivery principles.

Integration Joint Board members will come from a variety of backgrounds. Some members may not have had much/any experience of sitting on the board of a public body. All Integration Joint Board members will require induction training to ensure that they are able to carry out their duties to the highest standard. The training and information requirements will of course vary from member to member, and Integration Joint Boards locally decide how best to organise and operate their induction training requirements.

All members should receive an induction; as a minimum this should cover the member's specific post requirements, roles, responsibilities and policies.

The Scottish Government have produced On Board: A Guide for Board Members of Public Bodies in Scotland which can be used as a standard induction pack covering generic issues such as roles and responsibilities of public bodies, and accountability and governance arrangements to supplement the tailored induction that individual Integration Joint Boards will wish to produce.

The Scottish Government has also produced Leading the Journey of Integration: A Guide for Organisational Development Leaders to support the development of Integration Joint Boards. The guide highlights the important roles that are required for the integration of health and social care to be a success. It sets outs key information paired with development exercises which can be used individually or collectively by an Integration Joint Board. The guide can be found on the Adult Health Social Care Integration Implementation Website.