Agenda item - MOVING TOWARDS INTEGRATION: UPDATE ON DEVELOPING AN INTEGRATED MODEL OF CARE, INTEGRATED URGENT CARE AND PRIMARY CARE STRATEGY

Report of the Director of Commissioning at NHS Brighton and Hove Clinical Commissioning Group.

45.1                 RESOLVED:

That the Board:

1.     Noted the national and local strategic case for change to integrated health and social care services.

2.     Noted developments and progress that had been made so far with developing our services towards integration.

3.     Supported the proposed approach to deliver integrated health and care through a Partnership Approach, as an alternative to options such as forming new organisations or only integrating healthcare. Formal agreement will be sought at the January Health and Wellbeing Board.

4.     Supported the proposals to develop local primary care models including the development of Health and Wellbeing hubs in the city.

5.     Supported the approach to deliver integrated urgent care services in the city.

45.1                 Chris Clark, Director of Commissioning Brighton and Hove, introduced a report on the update on what an Integrated Health & Care Partnership model could look like within the city, further information on the Primary Care Strategy and explained the developing model for Integrated Care Services.

45.2                 The Chair commended that the plans recognised GP practices that pushed for a change for better services. She stated that in terms of integrated partnership between the public, organisations and people outside the city it was important to retain democratic oversight and a caveat of accountability. She asked if the Weymouth or the Manchester model had new funds for the integrated care partnership to operate or was it a budget shifted from other services.

45.3                 Chris Clark responded that Manchester did receive new funds however he was not aware of any new money for Brighton & Hove to support integration. The government had announced as part of the NHS funding settlement specific transformation funding which would further clarify on how that money was to be invested that would come with the NHS planning guidance, which would be published in early December 2018. He stated that there was an opportunity to create investment by shifting the focus from A&E services in to a community based structure that would release funds and said that they are able to do anything but could not do everything. In January there would be options to discuss how proposed models would work within the commissioning structure, see what models health partners would feel comfortable with and look to other successful integration models in the country.

45.4                 The Chair stated that the ambitions for integration were for a health partnership and not a merger approach.

45.5                 Councillor Taylor stated that he backed the transformative integration strategy that was necessitated by the changing nature of people’s needs which has been planned for decades. He stated that partners should focus on enhancing their relationships and must be careful not to create any unnecessary new structures. He added that he wanted to see more clarity in the January report and stressed that success of the model was reliant on the governance strategy.

45.6                 In response to Councillor Page, Chris Clark explained that a final decision on the walk-in centre had not yet been made. When these plans have been finalised they will be taken to the Health Overview & Scrutiny Committee (HOSC) for consultation. It was necessary to understand what precisely the centre currently delivers in order to ensure that any replacement provides improved evening, walk-in and GP led services. Mr Clark stated that this plan would channel people in to the services that are best suited to their need, support closer to home visits and relieve pressure on hospital services.

45.7                 In response to the Chair, Chris Clark stated that the intention was to bring plans to the January HOSC, including plans for the walk-in centre.

45.8                 Councillor Moonan stated that the integrated care model was complex and important to the city so other committees should keep sight of progress.

45.9                 David Liley, Brighton & Hove Heathwatch, stated that he recognised the good work around integration and its intentions in the context of significant financial constraints in this CCG and alongside the Strategic Transformation Plans (STP). He stated that he hoped lessons had been learnt from the tragedies of disintegration, Kendal Court a prime example, and that it was crucial that housing services were involved. Healthwatch had been nationally asked for public engagement with the NHS long-term plan which would come with a small amount of funding to link with parts of the city.

45.10             Chris Clark stated that the context of the budget would change with integration. Partners would plan investment together and address challenges collectively. He responded that housing services and supported patient engagement in the long-term plan should be part of the process along-side reducing waste in the system.

45.11             The Chair stated that there would be a more detailed report about the health and social care partnership in the January HWB. She stated the she would seek clarity and reassurance for the public on the oversight and accountability through elected members and the HWB. In terms of finance it needed to be clearer whether there would be new or redistributed funding and each organisation retaining financial control of their money.

45.12             The presentation could be found on the following link:

http://phantom.brighton-hove.gov.uk/Published/C00000826/M00008124/AI00070586/$MovingTowardsIntegrationIntegratedCarePartnershippresentationPDF.pdfA.ps.pdf

45.1                 RESOLVED:

That the Board:

1.     Noted the national and local strategic case for change to integrated health and social care services.

2.     Noted developments and progress that had been made so far with developing our services towards integration.

3.     Supported the proposed approach to deliver integrated health and care through a Partnership Approach, as an alternative to options such as forming new organisations or only integrating healthcare. Formal agreement will be sought at the January Health and Wellbeing Board.

4.     Supported the proposals to develop local primary care models including the development of Health and Wellbeing hubs in the city.

5.     Supported the approach to deliver integrated urgent care services in the city.