Issue - meetings

The Committee will receive a verbal update from Alan Foster, Durham Darlington and Teesside Hambleton Richmondshire and Whitby STP lead officer which will cover the following issues:-

·                     The future of Sustainability and Transformation Plans;

·                     Development of an Integrated Care Partnership/System/Network and what this means in relation to the STP;

·                     Progress updates on the STP workstreams including the Better Health Programme/Acute Hospitals Model development.

Councillor Robinson referenced a recent press article in the Northern Echo which detailed discussions that had taken place at a meeting of North Yorkshire County Council regarding the future of health service provision at James Cook University Hospital, Middlesbrough; University Hospital North Tees, Stockton and Darlington Memorial Hospital. He stated the article suggested that key services would be retained at Darlington Memorial Hospital and this had raised issues with the DDTHRW STP Joint OSC members given their previous request for appropriate communications to be issued by the STP lead/Commissioners in respect of the development of the three acute hospitals model that had been discussed at the Committee’s meeting in January 2018.

In response, Mr Foster indicated that he had been disappointed in the press coverage on this issue and suggested that this may have been inaccurate. He stated that the press statement asked for by the Committee in January had not been issued because of difficulties that had occurred in getting all representatives to sign up to any press release. He introduced Mary Bewley, Head of Communications and Engagement, North of England Commissioning Support to members and indicated that an updated position statement in respect of the development of the STP/Better Health Programme and Integrated Care System would be published on 14 June 2018. This will be circulated to Local Authority Chief Executives; Directors of Adult and Children’s services and Directors of Public Health along with Health Scrutiny members and Health and Wellbeing Board representatives.

Mr Foster then gave a presentation to members which set out proposals for the development of an Integrated Care System for the North East and Cumbria which included associated leadership structures and governance proposals.

Mr Foster reported upon the context for the NHS within the North East and Cumbria, referencing the fact that the NHS Cycle is driven by poorer population health as a starting point leading to an overdependence on hospitals. NHS Funding is drawn away from prevention and preventative services which stops the causes of poor health from being addressed. Ill health within the region also contributes to worklessness, poor productivity and lower economic growth. The associated opportunity cost is poorer health outcomes in areas such as life expectancy at birth; smoking related deaths; under 75 mortality from cardiovascular disease and cancer.

In setting out the case for change, Mr Foster stated that the NE and Cumbria had a long established geography with highly interdependent clinical services. The vast majority of patient flows stay within the area and there is a history of joint working and a unanimous commitment from NHS organisations to establish an Integrated Care System across the North Eats and Cumbria. However, he stressed that the 2012 Health and Social Care Act had led to fragmentation across the health system making system wide decision making difficult. This coupled with significant financial gaps, service sustainability issues and poor health outcomes had led to further challenges.

The proposed changes would see the replacement of three STPs across the North East and Cumbria  ...  view the full minutes text for item 6

The Committee will receive a verbal update from Alan Foster, Durham Darlington and Teesside, Hambleton, Richmondshire and Whitby STP lead officer which will cover the following issues:-

·                     Ongoing engagement between with the Chief Executives and Leaders of local authorities in the STP footprint and what the relationship is between that group and this Joint Health Scrutiny Committee;

·                     Potential timeframes for the development and commencement of formal consultations in respect of the STP and associated service proposals;

·                     Governance and the role of the CCG Joint Committee and the committee of Foundation Trusts;

·                     Cross STP boundary work within the North East;

·                     The development of an Accountable Care System and associated governance arrangements.

Alan Foster, Durham Darlington and Teesside, Hambleton, Richmondshire and Whitby STP lead officer, provided a verbal update which on the development of the STP and the Accountable Care System for the North East and Cumbria.  The key elements of the update and subsequent discussions are summarised as below.

•           Winter pressures and operational issues have been the focus over the past 3 months and so strategic work has not developed as fast as previously envisaged

•           Engagement and dialogue is continuing with a broad range of strategic partners, including local authority chief executives, Clinical Commissioning Groups (CCG), Mental Health Trusts, the Ambulance Services, Directors of adult social care and public health.

•           More work is needed to build a narrative that outlines exactly what it is that the STP is trying to achieve and how it will do it.

•           The previous approach, which had been developed through the Better Health Programme, did not engage widely enough with or find support from the public and local politicians.  As such, a new way forward is needed.

•           CGGs have developed Joint Committee arrangements to help progress the development of proposals for services changes that are over an area larger than an individual CCG footprint.

Alan Foster then said that there had been some correspondence following on from a meeting in Darlington with local authorities in the STP, which outlined a development plan which had 14 workstreams.  The intention had been to share this more widely but sickness and Christmas had prevented this.

A quick summary of the 14 workstreams was provided although it was noted that they had yet to be formally agreed by the CCG Governing Bodies.  It was anticipated that this should be achieved by the end of January 2018. The STP Workstreams were:-

1.         Cancer survival rates – compliance with the 2 week rule and the 62 days diagnosis to treatment rule;

2.         Demand management – finding alternative ways of dealing with demand that does not need to come into hospital and which can be better managed in different settings;

3.         Learning Disability and mental health – achieve nationally set goals, such as parity of esteem for Mental health services;

4.         Neighbourhoods and communities – applying what has been learnt from what has been done in the upper dales and other rural areas about out of hospital care;

5.         Acute sector – development of a blueprint for hospital services;

6.         Pathology – more efficient delivery of services.  This is largely an operational issue but crucially important for quick and effective diagnosis;

7.         Prevention – this is being led by the Director for Public Health from Newcastle but engages all DPHs across the STP footprint;

8.         Urgent and Emergency Care – learning lessons from pilots about how we can better manage bed space;

9.         System development – sharing innovation and good practice;

10.       Digital Care – how greater used of digital technology can increase efficiency;

11.       Estates – how the NHS estate can be used better and exploring opportunities  ...  view the full minutes text for item 5