Agenda item - Sustainability and Transformation Plan - Presentation

Presentation from the Chief Operating Officer of the Clinical Commissioning Group (copies attached).

76.1.        The Chair stated that the future of the NHS was being looked at and he hoped that the presentation would give some insight into what was being considered.  He also noted that there were three public questions in regard to the item and he would therefore take them after the presentation.

76.2.        The Chief Operating Officer of the CCG gave a presentation on the Sustainability and Transformation Plan, (STP) which was the proposed new planning framework for NHS services that had been announced in December 2015.

76.3.        The Chief Operating Officer noted that it was still early in the process in terms of finalising the new framework and that it would need to reflect the previous plans that had been referred to in earlier discussions.

76.4.        The Chair thanked Mr. Child for his presentation and invited Mr. Graham to put the first public question to the Board on behalf of Mr. Walker.

76.5.        Mr. Graham thanked the Chair and asked the following, “What impact does the Health & Wellbeing Board believe the Sustainability and Transformation Plan and the new geographic alliances which are being generated to implement it, have on health and social care services in Brighton and Hove?  What analysis of this and other potential impacts of such radical change in the organisation and structuring of health and care services, for e.g. socio-economic, have been carried out or are planned?”

76.6.        The Chair noted that Ms. Mainstone had not been able to stay for the item and read her question, “According to the STP Planning Guidelines issued by NHS England, the success of the Plan ‘depends on having open, engaging and iterative processes that harness the energies of clinicians, patients, carers, citizens and local community partners and local government.’  Can the Board explain how they plan to comply with this instruction on this issue of unprecedented significance for our local democracy and for all residents of the city?  Are local trade unions being consulted about the budgetary and staffing implications?”

76.7.        Ms. Dickens then asked the third public question, in regard to item 4.9 page 55 of the February HWB agenda, recommending “Return the system to aggregate financial balance.  Efficiency savings with the Lord Carter provider productivity work programme, complying with the maximum total agency spend and hourly rates set out by NHS Improvement.  CCGs to deliver savings tackling unwarranted variation in demand through implementing the RightCare programme in every locality.”  How would ‘aggregate financial balance’ be achieved with the current BSUHT deficit of £37 million, what would such mechanisms mean in relation to savings and cuts in NHS budgets and what consultation has there been with unions involved?”

76.8.        The Chair thanked the questioners and in regard to Ms. Mainstone’s question stated that the position had not been reached as yet.  There had not been any public engagement or discussions with the Board in regard to the STP, although input had been and was being made by the CCG and officers.

76.9.        The Chief Operating Officer stated that it was still too early to be able to respond to the questions.  The STP was likely to go across a wider footprint and include economies of scale.  He noted that the Chair of the STP Programme Board had recently written to the Chairs of Health & Wellbeing Boards asking for their views on how public engagement should take shape and noted that it was too early to involve the trade unions.  It was intended to develop an engagement plan and once this was agreed a lot of the questions being raised would be addressed.

76.10.     The Chair suggested that there was a need to enable engagement in the process before a final version of the STP was determined and stated that he hoped there would be an opportunity to influence the make-up of the Plan.

76.11.     Ms. Dickens asked a supplementary question, did the Board anticipate that greater aggregation would result and workforce savings that would lead to implications for the future of the NHS?

76.12.     The Statutory Director for Adult Services stated that she was a member of the STP Programme Board and other partner agencies were also represented on the Board.  There was a degree of concern about the level of engagement that could be achieved when the Plan was due to be submitted by the 23^rd June.  She had put herself forward to sit on the Southern Regional Board and hoped that greater clarity would be forthcoming.  However, it was not possible to answer the question at this stage.

76.13.     Councillor Barford stated that it was important to be able to have a level of engagement that people trusted and hoped that this would be given further consideration.

76.14.     Pennie Ford stated that it was early days for the development of the STP and that there would be different levels of planning, with local integrated work being a core element of provision along with areas that needed a wider footprint e.g. mental health and workforce challenges. 

76.15.     The Statutory Director for Children’s Services noted that the current version of the STP had a lack of reference to Children & Young People and hoped that this would be addressed.

76.16.     Councillor Mac Cafferty referred to figures published by the King’s Fund which suggested that there would be a 20% cut in the NHS by 2020.  He fully understood why people were anxious about the way forward and suggested that the Board could submit a request for the process to be halted pending a consultation process being undertaken before any decision was taken.

76.17.     Councillor Penn stated that she wished to echo the comments made by Councillor Mac Cafferty and queried how many people were aware of the process and proposals contained in the STP.  She felt that there was a need for more engagement and to raise awareness of the situation.

76.18.     The Chief Operating Officer noted the comments and stated that the Chair of the Board had been asked for comments on the engagement process by the Chair of the STP Programme Board.  He also stated that he would take on board the point raised about Children & Young People.

76.19.     The Chair stated that he was happy to write to the Chair of the Programme Board and reflect the Health & Wellbeing Board’s concerns/views.  He would also invite him to attend the next meeting of the Health & Wellbeing Board.

76.20.     RESOLVED: That the information contained in the presentation be noted.