That brings us to our next item, which is a statement by the Minister for Social Services and Public Health on integration and partnership working in health and social care. I call on the Minister for health to make her statement—Rebecca Evans.

Thank you. It has now been over a year since the commencement of the Social Services and Well-being (Wales) Act 2014, which is now transforming the way that care and support services are delivered across Wales. I have been pleased to be able to see for myself how this legislation is resulting in improved outcomes for people within our society with the most need. It is also helping to ensure services are sustainable, despite the ongoing austerity imposed by the UK Government.

This statement updates Assembly Members on progress in providing the integrated and collaborative approach to care services, which is at the core of the Act, and is a statutory requirement of it. The Act provides for regional partnership boards as the driver for the integration agenda. Seven boards have been established across Wales on the health board footprint. They bring together health, social services, the third sector, private providers and citizens.

I have met with the chairs of these boards, most recently in July, to discuss their progress in delivering effective and efficient integrated services. I am pleased that these boards are now firmly established, and I pay tribute to their members for their leadership and their hard work to date. The Welsh Government, however, recognises the importance of engaging closely with them to support their ongoing implementation. We have held a series of events across Wales over the last 12 months to support regional boards and consider different aspects of their roles. This support will continue based on what help the partners tell us they need.

One of the boards’ notable achievements has been the publication in April of population assessments as required by the Act. I know undertaking these assessments involved a significant process of engagement and analysis. These valuable reports provide a clear evidence base at regional level of the broad range of care and support needs. Partners are now working towards the production of joint area plans in response to those assessments. These plans must be produced by April 2018, and they will set the agenda for regional partnership boards. I have instructed boards to use this process to consider strategically how they will further strengthen their integrated arrangements.

Alongside the legal framework of the 2014 Act, Welsh Government is also providing significant financial support to encourage further integrated and collaborative working via the rebranded integrated care fund. A further £60 million has been made available across Wales this year, and our programme for government includes a commitment to retain this important fund. Since it was established in 2014, the ICF has been used to develop a wide range of innovative models of integrated working. These are credited with having helped prevent unnecessary hospital admissions and enabling older people to maintain their independence. The scope of the ICF has gradually expanded so that its objectives now encompass regional partnership boards’ priority areas for integration. Whilst the fund continues to support intermediate care services, it is also being used to support integrated services for people with learning difficulties and children with complex needs, and now carers are within the scope of the fund. These objectives will remain in place for three years, and this will provide more certainty for regions and enable them to plan strategically in response to their population assessments.

An independent consultant was commissioned to help regional partnership boards identify good practice in relation to initiatives taken forward through the ICF. The findings have assisted in ensuring the fund’s objectives and improved reporting arrangements now focus on achieving well-being outcomes. Over the summer I visited a number of varied and exciting projects made possible because of the ICF, and saw clearly the positive focus.

I’ve decided to commission a large-scale review of the ICF during the next financial year. The purpose of this work will include identifying nationally the benefits of how this money is spent by the regional partnership boards and determining whether value for money has been achieved.

I am clear that the positive achievements of the ICF derive from it being spent collectively by partners. Doing things 22 times is not sustainable. The ICF therefore represents one clear example of regional partnership boards delivering their key priority of making more effective use of resources. A further example can be seen in the expectation contained in statutory guidance that partners put in place an integrated commissioning process. This includes joint commissioning strategies as well as common approaches to setting specifications, agreeing fees and quality assurance. This allows local authorities and health boards to focus on improved quality as well as securing better value for money.

Regions are required by the Act to establish pooled budgets in relation to the provision of care home accommodation for adults by April 2018. These pooled funds will significantly support, and be a natural progression of, their joint commissioning arrangements. I’ve consistently made clear that my expectation is that these pooled funds are established jointly at the regional level between the health board and all the local authorities within the partnership area. We are all committed to effectively delivering quality services that improve the well-being of our people, and that can only be achieved by determined collaboration between partners that leads to real and sustainable integrated working. Those outcomes cannot be fully achieved by anything less than a full commitment to working together. Local authorities and health boards must have frank conversations about how public money can be used to most effectively address regional needs. This approach to pooled funds is entirely consistent with the proposals for local government reform.

Following responses to a consultation in 2015, the requirement for pooled funds for care homes was delayed until April 2018. By any standards, partners have had ample time to plan for this requirement and I asked regional chairs to write to me by the end of September, setting out their progress. Whilst they identified challenges, partners generally expressed their ambitions to move towards regional joint commissioning progress, and I am encouraged by that, but there should be no doubt that this must include working to pooled budgets. The Welsh Government organised a national event to discuss the opportunities and challenges presented by pooled budgets last week. We will arrange additional support for regions in the coming months to help them establish and manage pooled funds on the basis that I outlined earlier. I will assess progress again early in the new year.

I acknowledge that regions have made progress in establishing these pooled budgets. I also recognise, however, that there remain issues about some regions’ ability to fully implement this requirement by April. If, however, I am not satisfied with the way this requirement has been delivered in each region by the end of the forthcoming financial year, I will need to consider options for more direct intervention. These are critical services that deal with some of our most vulnerable people.

We all recognise the challenges in delivering integrated and collaborative services. It will require new ways of working and significant cultural change. People, however, do not care where health services end or where social services begin. They want seamlessly integrated care and support services, and Welsh Government will continue to provide the leadership and the investment to ensure this essential change. Thank you.

Minister, I’d like to thank you for your statement today. I also welcome the publication of the population assessments, although I am extremely puzzled as to how these health boards and other organisations managed to make strategic plans in the past without such a thing. I am very surprised to hear that it took so long to deliver them, because I would have thought that a key component of understanding what services you need to deliver is to know what the population is that you are serving.

Also, just a little bit further on from that, you talk about the fact of the regional boards and that they are to use this as part of the process to consider their strategic involvement. Can you just confirm whether or not the Welsh ambulance service trust is part of that proposal as well, because, of course, they are an integral part of providing joined-up services for health and social care?

You talk, Minister, of the integrated care fund, and money is always welcome, there is no doubt about it, however, during the scrutiny of the Welsh Government’s budget, it’s very clear that some health boards are stating that cost drivers and investments in key areas are not being mitigated by the required level of savings that they need to make. So, my question to you is: is this enough? What fallback position do you have, or what are you expecting the health boards and integrated service providers to do in order to make sure that there is enough money within these pools to go forward and provide the services that they need in their particular area? As I say, this is coming through loud and clear in the health committee scrutiny of the Welsh Government budget.

What metrics will you be using when you look at your large-scale review of the ICF? Have you actually given thought to how that will—or have your officials given thought to how that will be judged? What benchmarks will you be using? It is a question I raised with the Cabinet Secretary earlier on a previous statement. It’s all very well having these reviews, but you must have a framework within which you know that those reviews can work, and work well.

Your statement on integration and partnership working in health and social care today makes no mention of the integration of workforce planning. Will you be looking at that? Will you be asking those regional boards to look at that as part of their work process, going forward? Because there’s no point in having, for example, all the doctors and nurses in the world that we may wish—if only we were in that position—to then find we don’t have enough social workers to get people back out into their homes, et cetera.

You also don’t talk about how we can use these boards to foster a culture of innovation. I think what’s becoming very, very clear in both the parliamentary review and in leading evidence that’s being put forward by King’s Fund, et cetera, is that we need to have the ability to enable little green shoots of innovation to gather strength, to make these changes, to make sure that this integration works well. We have to bring on board the private sector into a public sector space. I would be very interested to know how you’re going to make that work and how you are going to be able to manage the not unnatural tension between big public sector monoliths, if you like, and the private care sector and, of course, our local authorities, which, as we already know, are very sad local authorities, having just received their budgets, and are wondering how they are going to be able to perform their part of this deal. Thank you.

I thank you very much indeed for those questions. You began by talking about the population needs assessments, and they’ve been tremendously useful in identifying some core themes, I think, that stretch across all of those population needs assessments. Loneliness and isolation has come out loud and clear as one of those particular areas across all of those population needs assessments, but poverty and deprivation, the importance to individuals of independence, and the importance of building resilience in individuals and communities, they’ve come across as themes in terms of the ways in which we can address the needs that have been identified within those population needs assessments. The needs assessments themselves cover eight core themes: children and young people, old people’s health, physical disabilities, learning disabilities and autism, mental health, sensory impairment, carers who need support, and violence against women, domestic abuse and sexual violence. So, I think they do give us a very robust and clear picture about the needs of those various different groups of people, right across those regional partnership boards. It’s my intention to publish a national population needs assessment based on what we’ve heard from the population needs assessments at a regional level, because they have been so illuminating and so interesting, so I’ve asked Social Care Wales to undertake that piece of work with a view to reporting in November. That’s the aim: to report at that date.

In terms of how regional partnership boards come to an agreement in terms of the pooling of budgets and how much they pool within those budgets, and do they have enough to meet the needs of the people they’ve identified through their population needs assessment, Welsh Government has provided statutory guidance under Part 9 of the Act, which gives an almost step-by-step route to pooled budgets. For example, it starts off with a population needs assessment, but then it moves on to agreeing an appropriate integrated market position statement and a commissioning strategy as a result of that, and agreeing common contracts and specifications, and developing an integrated approach to agreeing the fees with providers, and an integrated approach to quality assurance, whilst at all times maintaining transparency as well. So, those steps along the way should lead to a point where pooled budgets are the next natural progression, and that they’re pooled in a way that is informed and well resourced in order to meet those needs as well. So, those steps have been set out in statutory guidance.

You also asked how we can ensure that the ICF allows innovation, and that was one of the purposes that the ICF was set up for in the first place, in order to give people working in the sector and to give leaders in the health and social care sector the okay, if you like, to try different things and to do things differently. Actually, the ICF was set up to encourage innovation, and actually it was okay if things didn’t work; we could learn from that just as well as we learn from things that do work. So, innovation has always been very much at the heart of that, and there are some fantastic examples, of course. You might be aware of the Pembrokeshire Intermediate Voluntary Organisations Team, PIVOT, which has used £160,000 this year of funding to support timely and effective discharges from hospital, and also to improve opportunities for independent living within the community. To date, within this financial year, 1,320 bed days have been saved and 132 hospital admissions avoided, and there have been 80 supported discharges just within that particular project as well. So, lots of exciting things going on, and people thinking in a very different way.

In terms of workforce planning, again this is something that Social Care Wales has very much engaged with in terms of their new and expanded responsibilities in terms of the development and oversight of the workforce in Wales. They work very closely within the sector and with the regional partnership boards as well.

Finally, you mentioned the private care sector as well, and how we’re ensuring that we recognise the important partners that they are within all of this. Well, the regional partnership boards, through the social services and well-being Act, are mandated to have a representative of the independent sector on each and every one of those regional partnership boards, so that they can give their unique perspective to those boards as well.

There are two main elements to the statement and I thank the Minister for that statement. The first of those elements is that there’s been some praise of some elements of the integrated care fund—previously the intermediate care fund. I will take this opportunity, if I may, to remind the Chamber that that fund was part of a budgetary agreement with Plaid Cymru, and we’re pleased that we brought that idea to the table because of the way in which we have seen it being developed. The main element of the statement is this broader context of pooling budgets and working in partnership, and I have a number of questions arising from that. The statement suggests that local authorities and health boards somehow aren’t fully committed to these regional boards:

Nid oes modd i’r canlyniadau hynny......gael eu cyflawni drwy ddim llai nag ymrwymiad llwyr i gydweithio.

What do you think is the main barrier to getting that kind of full commitment to the success of the boards? You remind us that, after consultation, there was a deferral in the need for pooled budgets to care homes until 2018. I agree with you, or with the suggestion, that this provides sufficient time, but, in reading between the lines, it appears that some partners are finding this difficult, still. And in that context, do you, as Minister, regret extending that deadline on the basis that it appears that, whatever the deadline is, certain partners will have difficulty in committing to it?

Do you also acknowledge that the separation of health and social care, and the lack of statutory responsibilities, mean that there is always a risk that what partnership working would mean would be managers meeting to argue what their contribution to the pooled budget should be and to ensure that it was as small as possible, and that the limitations of partnership working without statutory obligations are quite clearly displayed? And I may ask, too, for your comments on the alternative option, namely providing a specific budget to the regional boards, rather than the local authorities and the health boards separately.

The next question is that the Welsh Government has been against introducing structural changes to merge health and social care, arguing that such changes would be expensive and disruptive too. So, why, then, are you planning to change health in Bridgend from Abertawe Bro Morgannwg to Cwm Taf and not even taking that opportunity to create a more integrated body, where resources would be targeted at front-line services, when you have taken that decision to make a structural change?

Next I will remind you of a few Plaid Cymru amendments that were rejected by the Government when the social services Act was discussed. One of those was to allow local authorities to directly employ registered nurses, thereby providing opportunities for them to develop stronger social care. Do you regret not agreeing to those amendments? Also, referring back to what I said earlier, our amendment 2 in order to strengthen the real duty that should be placed on health boards and local authorities to collaborate on merged or pooled budgets; that is, we were saying that they should, rather than ‘they should consider’ or ‘they should be able to’.

And finally, today we hear local authorities the length and breadth of Wales responding with some understandable concern in terms of the announcement on their draft budget, that they are facing years of cuts—more cuts. Do you, as Minister, believe that it is possible for social services to maintain the level of service that they currently provide, never mind strengthening and improving those services, within the context of a shrinking budget for local authorities, whilst simultaneously there is an increase in demand for their services? Shouldn’t we, if truth be told, be thinking in earnest about a single budget for health and social care? Because I would argue very strongly that it is misleading to highlight an increase of £200 million in healthcare if social care, which has such a knock-on impact on the NHS, is to see reductions or is at risk of seeing reductions in future years.

Thank you very much. I would begin by saying that, in those letters to which I referred in my statement, where all chairs of regional partnership boards wrote to me by the end of last month, providing an update on the progress—each of those letters included an update on the progress towards those six different steps towards pooled budgets, which I spoke about in my response to Angela Burns, and it is fair to say that various regions are at different stages on that journey, but we’ve been absolutely clear that Welsh Government will provide whatever support is necessary to get them to the point where they are able to pool those budgets. But there is absolutely no question that all of those regions are fully committed to pooled budgets. I’ve spoken to the chairs of regional partnership boards, I’ve had meetings with the chairs of the health boards, for example, just yesterday, I met with all of the leads in local government who have responsibility for social care, all of whom are completely behind pooled budgets and recognising the importance of it. So, there’s no question, I don’t think, in terms of the commitment to it. In terms of the actual practicality of it, it is a tremendously complex thing to do, but, as I said in my statement, Welsh Government will provide whatever additional support is needed to get to that point.

In terms of partnership working, it’s not really about managers talking; the actual real partnership working is what happens in terms of, on the ground, how the individual receiving care and support has that care and support need met. You’ll probably be aware of examples in your own area in north Wales where the regional partnership board has allocated £1 million this year to improve their step up, step down services. So, that’s supporting people who are coming out of hospital who are medically fit but still require some degree of care and support. Over 800 people have already benefitted from this service and more than 2,000 bed days saved as well.

Additionally, in the north Wales region, over £1 million of the integrated care fund has been used to establish multidisciplinary, single point of access services, providing information, advice and assistance to individuals in a timely, effective and efficient way. Actually, many of the regional partnership boards have taken that approach in terms of that single point of access, just having seen how effective it is.

You referred to Bridgend, and, of course, in the statement to the National Assembly on 18 June, the Cabinet Secretary for Finance and Local Government said that we proposed that the Cwm Taf local health board boundary should be adjusted to include the Bridgend local authority area. Working with our partners in local government and health boards, the Government will discuss that proposition and develop a formal consultation document and a further statement will be issued on this this autumn. But I can confirm Welsh Government has already begun to engage very closely with the partners in Cwm Taf and the Western Bay regional partnership board about potential transitional arrangements if the boundary of Cwm Taf were to be extended to incorporate Bridgend as well. I think that it’s important that we take all of our regional partnership boards and all of our local authorities and health boards and treat them in the same way, rather than having bespoke arrangements for individual health boards and so on as well.

In terms of the specific budget, you’re right, there is more than one way to pool a budget; that’s certainly true. However, the preference has always been to encourage and give the freedom to local authorities and health boards, through the regional partnership boards, to take ownership of it and to take the leadership of the pooling of budgets themselves. I think that’s a more effective way and a more desirable way, certainly, than having Welsh Government impose that pooling on them. However, I’ve made it clear in my statement as well today that, if I’m not satisfied by the progress that has been made, I will consider other ways to pool budgets as well.

If I may, just on one more point, you did mention the difficult settlement that local authorities are having to deal with. It’s the result of seven years of austerity and diminishing funds to Welsh Government, and of course you will have read the Minister’s statement, outlining the settlement that has been made. However, I do think that collaboration and partnership working does provide local authorities with opportunities in the sense that, when pooled budgets do come into place and we commission jointly those adult care home places, there’s great opportunity actually to be doing things seven times rather than 22 times, sharing expertise and sharing the benefits of those wider commissioning arrangements as well. So, there are opportunities, certainly, with this approach.

Thank you for your statement, Minister. The 1000 Lives campaign has shown what is possible when we are united in the pursuit of a single aim—an aim of improving each patient’s experience of the care they receive. The enthusiasm and commitment of healthcare teams is highly admirable. Working together by following an evidence-based approach, they have continued to produce positive results and make significant improvements to patients’ experiences and safety. We must therefore acknowledge that, however hard we try, human error continues to be a fact of life. Therefore, we must continue to explore positive reforms to the management of our health service, and at all times prioritise patient care and safety.

First of all, we must recognise the scope of any issues and problems and make a clear commitment to change flawed systems that fail patients during their treatment and care. Improving each patient’s experience within our Welsh NHS requires everyone within it to work collaboratively with both the patient and their families. A vital component to improving the experiences of patients and staff is cohesion between health services and social care, and, where this fails, the consequences can be severe. An example that I have mentioned in this Chamber, but I feel it is important to raise, was the case of the 83-year-old gentleman from my region in South Wales West who underwent major surgery and subsequent treatment, and he experienced the flaws in the system and failed to benefit from collaborative care between health and social services. There simply was no plan when he was released from the hospital and no-one was told he was coming home from the hospital, and he’d had a triple heart bypass at 83 years of age.

So, does the Minister therefore agree with me that integration between these services must include streamlining the information patients are obliged to submit, thereby preventing a patient from having to give, as in this case, the same information to multiple agencies and professionals and in the end not achieving the result, improving the information sharing, which, in this case, didn’t happen, and ensuring health and social care services complement each other, establishing greater co-ordination between the two? Do you consider the role of local authorities in this instance to be positive? What experiences have you had when you’ve been negotiating, talking to, local authorities regarding these issues? One of the major challenges that faces the smooth transition from health services to social care is the delayed transfers of care. Since the middle of the last decade, we’ve witnessed rapid improvements in the number of people who experience delays. Indeed, the number has come down from 775 in the quarter ending in December 2004 to 472 in the quarter ending December last year. We all know workforce planning is vitally important, and each health board has stated that the cost of agency staff because of shortages is really eating into their budget and absorbs an awful lot of cost. So, this is a huge task, and I ask how you will address this issue, please.

Despite this considerable decrease in delayed transfers of care, it is noticeable that, since 2010, the number of delayed transfers of care has plateaued. I appreciate that there is always going to be a fluctuation in these figures. However, in 2013, there were 5,393 delayed transfers of care compared with nearly 6,000 in 2016. So, one of the main causes for these delays is the availability of beds, since the 2010 number of available beds has decreased by 15 per cent. At a time when Wales is experiencing increasing demands on the NHS service, the provision of beds is fundamental to reducing the number of delayed transfers of care. So, the 15 per cent reduction puts further strain on services and has an adverse effect on a patient’s experience. So, in particular, elderly people are suffering delays in their care, often left in hospital because there is no place for them to go—so, services, which in recent years have experienced cuts to their budget, exacerbating the problem further. Does the Minister agree with me that the Welsh Government must address the number of readily available beds to relieve pressure in Welsh hospitals and, furthermore, do everything within its power to prevent the closure of care homes across Wales?

Cuts to social services budgets have placed greater pressure on social care when patients are transferred from hospital. This is especially relevant to the elderly, many of whom experience a delay in their transfer and are reliant, therefore, on social services for the essential support that they receive. For example, Cardiff Council faces severe cuts to its budget over the next three years. The council has already made £200 million-worth of savings in the last 10 years. If further cuts—[Interruption.] If further cuts are to be made to council budgets such as Cardiff’s, then the capabilities of social services are going to be increasingly restricted, leaving many patients, both young and old, without essential care.

If social services are unable to keep up with the demand, then there is inevitably going to be a knock-on effect on the availability of beds in hospitals. So, this has a further effect on the transfer of care, causing greater obstacles to providing integrated care services.

As councils, not just here in Cardiff, but throughout the whole of Wales, face economically challenging times, will the Minister prioritise vital funding for the provision of social care for the elderly and the most vulnerable in our society, and consider the recommendations I gave earlier in my speech, ensuring that all in our health service benefit from collaborative health and social care? Thank you.

I thank you very much for those questions and begin by also recognising your comments particularly on the enthusiasm and commitment of the people who are working on the front line in health and social care—I’ve seen that for myself when I’ve visited many of the ICF projects that are taking place across Wales. I’d certainly, as always, encourage Members to go and visit the projects to be inspired by the kind of innovative working and sheer enthusiasm that people have working on the ground through the ICF.

Also, you said about the importance of prioritising the individual, and that’s exactly what the Social Services and Well-being (Wales) Act 2014 sets out to do, in the sense that it puts the individual at the heart of the decisions that are made about them. It’s about personal outcomes, having that ‘what matters’ conversation with them to understand what it is that the individual would like to achieve, and understanding that they are equal experts alongside the professionals—they’re the experts in their lives, so they should be treated as equal experts in those conversations.

You also made the point that the cohesion of health and social services is absolutely crucial, and I couldn’t agree with you more. You gave a very distressing case as an example of just why it’s so important that we do have cohesion between health and social services. Again, this is something that the integrated care fund seeks to deliver. For example, in Cwm Taf, they’ve spent £1 million to develop a Stay Well @home service. That’s operated seven days a week, 365 days a year, and it consists of a multidisciplinary team based at the hospital, in the Royal Glamorgan and Prince Charles hospitals. They undertake initial assessments of individuals and commission or provide health, social care and third sector community support to facilitate the safe and timely return home of people and prevent unnecessary admission in the first place, so making sure that people do have that wide package of support around them, taking in health, social care and the third sector to ensure that there is a package to allow people to stay home.

You also talked about the importance of people not having to give their story many times, because that can be distressing and there’s absolutely no need for it in a time when we have such access to technology and so on. That, actually, is one of the things that they’re using in the Stay Well @home service in Cwm Taf. We’ve also invested £2 million of the ICF this year specifically in the Welsh community care information system, and that’s gone live between health and social services in Powys, in the first instance, so they have access to the same kind of information. I was happy to launch that particular initiative fairly recently, and had the opportunity to talk to staff, who said what a difference it makes to be able to access the information about the individual on the same level between health and social services. It’s gone live also in local authorities in Bridgend, Anglesey, Gwynedd, the Vale of Glamorgan, Ceredigion and Torfaen. Powys is the only area where it’s fully integrated at the moment, but we are moving towards that, and have provided £6.7 million of capital funding, actually, for the initial set-up and costs for an all-Wales licence—just demonstrating the priority that we are putting on that particular initiative.

I’m not sure I recognise the figures that you quoted on detox in terms of them being up-to-date figures, because they have certainly decreased again since the figures that you quoted to us. The total now is 7 per cent down on the same period last year, and in common with all the totals, actually, in the current year, it’s lower than any of the totals reported in the previous two years for the same months. So we are certainly making good progress, and this is at a time when individuals’ needs are escalating, as we have an ageing population, and so on. So this is certainly an area where we’re making very good progress.

One of the things that interested me when I first came into post in terms of delayed transfers of care was the fact that, actually, a large number of the delays are down to an individual’s choice. So, not being able to access their first-choice care home, for example. Lots and lots of the delays are down to that, which is why the Regulation and Inspection of Social Care (Wales) Act 2016 is so important in terms of driving up standards right across the sector so that people don’t have such a difficult choice to make when they’re weighing up the choices between two different care homes. Actually, we want to have a care home sector where all of the care homes are attractive to the individual, so there won’t be such reticence in terms of making those difficult choices as well.

Thank you for today’s statement, Minister. I’m sure there’s consensus in the Chamber that social care is one of the biggest issues and the growing challenges of our time and we need to better link up and have collaboration between health and social care to meet these challenges, and the question is, really, how we best do that in practice. Minister, you mentioned in your statement the responsibility of regions to establish these pooled budgets for the provision of care home accommodation for adults by April 2018, and I’m grateful for your previous responses on this. I just wonder whether you could add how this will work in practice and where we are in terms of making sure it does work effectively in practice.

You also highlight the importance of collaboration; are you able to expand on this and do you agree that collaboration in terms of pooled budgets and the integration agenda should include effective cross-party working? And the final point I want to make is: what consideration has been, or could be, given to how existing community assets could be better used or given a new purpose and use in an innovative and collaborative way to meet both the social care and health needs of the community—in particular in terms of looking at that kind of medical respite care gap for the elderly, the most vulnerable and frail, working hand in hand alongside social care? Is there also consideration of the role that, perhaps, the third sector could play in terms of maintaining and sustaining facilities to make sure that is better able to happen?

Thank you for those questions. You’re absolutely right that social care and social services are some of the big challenges that we’re facing in our time, and that’s why, in our programme for government, Welsh Government recognised the sector as a sector of national strategic importance. I’m really pleased that, within ‘Prosperity for All’ it has been recognised as one of the five key areas that can make the most difference to the people of Wales, and I think that’s really, really positive.

In terms of how pooled budgets work in practice, we’ve provided the statutory guidance to local authorities to describe that, and really pooled budgets are about an integrated approach to agreeing the fees with providers, agreeing specifications, and agreeing those financial commitments that each of the parties within the partnership will make.

The cross-party issue you suggested is actually very interesting in the sense that regional partnership boards are made up of partners brought together from across the sectors. So it is important that there is good cross-party working, and I certainly haven’t had any information to suggest otherwise. The third sector also are absolutely crucial partners, and that’s why, actually, on regional partnership boards, there’s a mandate for two people to be representing the third sector on those regional partnership boards, and I think that just is symbolic, really, of the importance that Welsh Government attaches to the role that the third sector can play in terms of meeting social care needs and also the expertise that they bring and the fact that they are very, very close to the grass roots, so that they can certainly be a voice for people who they represent as well.

The ICF also has a £10 million capital funding element to it, and that certainly does provide opportunities, perhaps, to make adaptations to existing facilities, and so on, in order to make them suitable to meet people’s needs. We’ve seen examples of this in some of the step-up, step-down services, for example, which have been tremendously successful in terms of preventing unnecessary hospital admissions, but also facilitating an earlier return home.

Just to develop this question of the regional partnership and the relationship between the pooled budgets, you explained to Hannah Blythyn that a whole variety of people can be involved in the regional partnership who will be responsible for spending that pooled budget, but the pooled budgets—if I understand the regulations correctly—are drawn from the LHB and local authority, not from other sources as well. If you bear in mind the Well-being of Future Generations (Wales) Act 2015 as well, do the LHBs and local authorities have any freedom to invite other partners to contribute to a pooled budget? I’m not clear from the legislation whether that’s possible. In those circumstances, or even if it’s just the LHB and the councils, obviously the amount that people put into pooled budgets is going to be different. Is there any weighting in real life with the people who are the most generous contributors to that pool, if I can put it that way? I know there shouldn’t be, but are you getting any sense from your visits that that might be a bubbling-under trend?

Citizens, of course, are part of the regional partnerships. You’ve spoken to the heads of these boards now. Can you give me some idea what citizen involvement actually looks like? It would be shocking to think that they’re just add-on advisers at some point, rather than being front and centre of these plans.

And then finally, I’m glad to hear that you’re evaluating the rebranded ICF; I notice you said that. Can you just give us some reassurance that the key performance indicators that you’ll be looking at in that—you didn’t quite answer Angela Burns’s question on this—won’t be significantly different from the KPIs that were originally anticipated when the unrebranded fund was set up? I think we need the confidence that there won’t be any changes on your targets, if I can put it like that, that would disguise shortcomings, unexpected or otherwise; I think we’d just rather know the truth. Thank you.

Thank you, and that’s one of the reasons that I’ve commissioned this large-scale look—or that I will be commissioning in the next financial year—at the ICF, and that is to find out the truth: you know, what kind of value for money are we having? We’ve already had the work done looking at examples of good practice, so we know that exists, but actually we need to be understanding the true value for money, and so on. In terms of the specifications of that piece of work, they haven’t yet been determined. So, obviously, I’ll be very much open-minded on that.

You’re absolutely right; the citizen involvement and citizen engagement have to be very central to the work of the regional partnership boards. The work that they did in terms of developing the population needs assessments was very wide-ranging, and there was certainly citizen involvement there. But on the regional partnership boards as well, there are service users and carers represented on those boards. It’s really important that they have a strong voice, as well as through citizens’ forums and so on, in terms of ensuring that, as the Social Services and Well-being (Wales) Act 2014 would have us do, putting the individual and the service user right at the centre as well. So, that’s absolutely critical. And, of course, the regional partnership boards do have a duty to make the local population aware of the work that they’re undertaking as well. I know that’s something that’s going to be discussed in the meeting with the chairs of the boards that is taking place tomorrow, actually.

In terms of who puts how much into the fund, that’s very much left for local determination, and I think that is the right thing to do in terms of allowing the partners to take that collaborative and innovative look together in terms of how they can come to an agreement as to who puts what into the fund. I know that those are not easy discussions but, actually, with the enthusiasm that there has been and the commitment that there has been from all of the partners involved, I’m confident that they can have those conversations without Welsh Government assisting.

Thank you, Minister. That bring today’s proceedings to a close.

The meeting ended at 17:54.