Agenda item

The Board received a presentation from the Clinical Lead for the Better Health Programme (BHP), North Durham Clinical Commissioning Group (CCG) and the Director of Commissioning and Development, North Durham Clinical Commissioning Group (CCG) that gave progress on the Sustainability and Transformation Plan (STP) and the Better Health Programme (for copy see file of Minutes).

The Director of Commissioning and Development highlighted the following points inrelation to the STP:

·         Overview of STPs

·         BHP – key elements

·         North East STP ‘Blueprint’ Event

·         Three gaps – Health & Wellbeing, Care & Quality, Funding & Finance

·         STP key priorities – early intervention and prevention, integration, reconfigure hospital based services and technology.

·         Timescales for final submission and ongoing discussions with NHS England and NHS Improvement.

Members were advised that Alan Foster, Chief Executive of North Tees & Hartlepool NHS Foundation Trust (NT&HFT) was the STP lead for the Durham, Darlington & Tees area.  He advised that guidance on the STP was awaited and that there continued to be ongoing work on the STP until final submission.

The Clinical Lead for the Better Health Programme gave an update on the BHP, including:

·         Governance Structure

·         Scenario Development

·         Modelling Process Overview

·         Why the Status Quo is not an option

·         Options and scenarios being considered under BHP

·         Phase 3 engagement update

·         Evaluation criteria including public and stakeholder views

·         Voluntary sector input

·         Next steps

The Chairman queried whether Health and Wellbeing Board comments would be fed into the STP.  The Director of Commissioning and Development said that a summary of work produced would be fed into the STP development.  He confirmed that all points would be considered.  The Clinical Lead for the Better Health Programme stated that the STP would be amalgamated with the BHP.

It was highlighted that the University Hospital of North Durham was in the Northumberland, Tyne and Wear footprint. Local authority representation was included in both of the STPs. The Clinical Lead for the Better Health Programme said that this arrangement was for planning purposes.

The Clinical Lead for the Better Health Programme confirmed that ‘out of hospital’ services would fit into both STPs. He also confirmed that the people of Durham had been consulted on the changes. 

Referring to the governance diagram, the Head of Planning and Service Strategy said that there was no mention of the Health and Wellbeing Board or local authority governance arrangements and suggested that they need to be included.

The Chief Executive of North Tees & Hartlepool NHS Foundation Trust (NT&HFT) advised that arrangements were in the transition phase and he gave assurances that the two STPs would ensure they work together for the benefit of patients.  The STP would add value and build on what was already in existence.  Any changes would ensure that the County had better and more robust services.  In terms of planning, the Chief Executive of NT&HFT advised that he was communicating with the STP lead for the North, in order to make services as local as possible.  The Board were advised that North Durham CCG would be involved in both STP areas.

The Chief Executive of NT&HFT concluded that the challenge was ensuring the right services were being provided and that the right people were involved, with integrated services being key.  He said that public health and mental health issues would also be challenging.

The Interim Corporate Director of Adults and Health Services (AHS), Durham County Council advised that the ‘not in hospital’ services would impact on social care and would have an impact on the local authority.  The Chief Executive of NT&HFT explained that residential and nursing home capacity would be a challenge and that he would work with the Interim Director and involve her in the work streams.  

Councillor J Allen welcomed the approach taken of working with the Gypsy and Roma Traveller Community but said that more needs to be done in persuading the community to visit a GP rather than presenting at hospital.  The Clinical Lead for BHP said that minority groups had been accounted for and that he would feed back further information when available.  The Director of Primary Care, Partnerships and Engagement, NHS North Durham and Durham Dales, Easington and Sedgefield (DDES) CCGs advised that engagement groups work with the GRT community and advised that Helen Moore was the Clinical Lead for this area of work.

The Interim Corporate Director of Children and Young People’s Services (CYPS), Durham County Council asked about the inclusion of the children’s agenda in the STP process.  The Director of Commissioning and Development advised that this was a key area within the STP and was a key priority in our patch.

The Interim Director of Public Health, AHS, DCC said that there had not been a lot of progress within the two STPs in terms of prevention and the Clinical Lead for BHP agreed that this area of work needed to be progressed further.  The Chief Executive of NT&HFT said that every contact counted and there was a real opportunity to change lifestyles.

Resolved:

(i)            That the presentation be noted.

(ii)          That further updates in relation to the Better Health Programme at future meetings be received.