Agenda and minutes

Councillor J Taylor (Darlington Borough Council)

Councillors B Brady, E Dryden and A Hellaoui (Middlesbrough Council)

Councillor J Clark (North Yorkshire County Council)

Councillors N Cooney, M Ovens and R Goddard (Redcar and Cleveland Borough Council)

Councillor L Grainge (Stockton-on-Tees Borough Council)

Daniel Harry, North Yorkshire County Council

Julie Gillon, Chief Executive, North Tees and Hartlepool NHS Foundation Trust

None.

None.

To receive and approve the minutes of the meeting of the Durham Darlington and Teesside Hambleton Richmondshire and Whitby STP Joint Health Scrutiny Committee held on 25 September 2018

Agreed that the minutes of the meeting held on 25 September 2018 be confirmed and signed by the Chair as a correct record.

(i)           Developing Integrated Health and Care Partnerships

Presentation by Alan Foster, STP/ICS lead

(ii)          Clinical Strategy Development – South Integrated Care Partnership

Joint presentation by the Chief Executives of County Durham and Darlington NHS Foundation Trust, North Tees and Hartlepool NHS Foundation Trust and South Tees Hospitals NHS Foundation Trust.

(i)      Developing Integrated Heath and Care Partnerships

Alan Foster, STP/Integrated Care System Lead gave a presentation regarding the development of an Integrated Care System (ICS) and associated Integrated Care Partnerships (ICP) across North Cumbria and the North East Region.

The Committee were advised that the North East and North Cumbria had declared their position as an aspirant Integrated Care System under a programme developed by NHS England and NHS Improvement. The North Cumbria and North East region currently consisted of 3 STP footprints which, under the ICS Programme, would develop a shared ambition to the best in England and Europe for health and care outcomes.

Mr Foster stated that the Cumbria and North East was a relatively high performing area for health and care albeit with some performance and finance challenges. It has a long established geography with a positive history of joint working across a highly interdependent system of clinical services where patient flows remain mostly within this area. Members have been advised in previous reports of service sustainability and configuration issues which have remained unresolved and fragmentation following the Health and Social Care Act 2012 that has made system wide decision making difficult.

The Committee noted that faster progress on improving health outcomes for the population was needed with more empowered patients supported by fully integrated health and social care. The system also needed to deliver a sustainable, equitable and affordable core offer of acute services as well as a strengthened collective decision making process for “at scale” improvement initiatives.

The presentation reaffirmed a unanimous commitment from NHS bodies to become an Integrated Care system with robust governance arrangements. The ICS would develop a vision and strategy supported by a suite of enabling workstreams. The ICS would create 4 Integrated Care Partnerships based upon existing population density/patient flows and hospital sites whilst preserving place based clinical leadership. These ICPs would be empowered to deliver sustainable acute services through managed clinical networks across multiple sites.

Mr Foster stressed that an ICS was not a statutory organisation in itself but rather an agreed partnership of individual organisations working to improve health and care based upon:-

•        Developing a shared vision and high-level plan across NHS organisations;

•        Reaching a formal agreement with NHSE/I to implement faster improvements in population health outcomes;

•        Taking devolved responsibility for key NHS resources, and

•        Collaborating across boundaries, e.g. clinical staff from different organisations working in networks ‘horizontally’ across hospitals but also integrating ‘vertically’ with GP and community services.

Integrated Care Partnerships were alliances of NHS Providers that work together with local commissioners to deliver care by agreeing to collaborate rather than compete. In this context providers could include hospitals, community services, mental health services and GPs as well as social care, independent and third sector providers.

Mr Foster also referenced plans by NHS England and NHS Improvement to develop seven joint regional teams led by directors tasked with developing more integrated local leadership. One of these teams would cover the North  ...  view the full minutes text for item 5.

Presentation by Stewart Findley, Chief Clinical Officer, Durham Dales, Easington and Sedgefield Clinical Commissioning Group

Stewart Findley, Chief Officer, North Durham, DDES, Darlington, Hartlepool and Stockton and South Tees CCGs gave members a presentation setting out proposals for increased collaborative working arrangements across Darlington; Durham Dales Easington and Sedgefield; Hartlepool and Stockton; North Durham and South Tees CCGs.

He reminded members that the Health and Social Care Act 2012 established the statutory role of the Clinical Commissioning Group and sets out the statutory duties and requirements including those roles which are considered ‘statutory’ requirements, namely, that appointment of a Chair of the Governing Body, a Chief Officer, a Chief Finance Officer and an Executive Nurse.

Dr Findley indicated that many CCGs around the country are now either merging or creating joint committees and collaborative arrangements with a single agreed leader/Accountable Officer. The annual leadership assessment of CCGs by NHS England now also includes a focus on collaborative working. As a result, he indicated that the 5 CCGs in Durham and the Tees Valley (NHS Darlington CCG, NHS Durham Dales, Easington and Sedgefield CCG, NHS Hartlepool and Stockton-on-Tees CCG, North Durham CCG and NHS South Tees CCG) had agreed to develop joint leadership and management arrangements. They appointed a single Accountable Officer from 1st October 2018 supported by two Chief Officers and a highly skilled Director team. He confirmed that the new accountable officer was Dr. Neil O’Brien.

Members were also advised that NHS Hambleton, Richmondshire and Whitby CCG would also work closely with the ‘collaborative’ on areas of mutual interest, such as acute services commissioning.

Dr Findley explained the relationships between proposed Integrated Care Partnership footprints and existing CCG boundaries.

The Committee was informed that the CCGs had indentified a number of benefits to be derived from working more collaboratively including:-

·         Working together to share expertise and capacity presents the opportunity to

learn quickly, shorten delivery timescales and achieve stretching ambitions.

·         Shared responsibility and delivery of the STP, working as key system leaders within a complex health and care system supporting the development of an

Integrated Care System and Integrated Care Partnerships.

·         Potential for greater overall clinical engagement and input.

·         Support for both clinical and managerial succession planning across all CCGs.

·         Greater potential for influence locally, regionally and nationally.

·         An opportunity to re-focus, re-energise and align the team to support both the local and wider complex and significant transformation agenda by working at

scale.

·         Reputational benefits for CCGs as joint working brings shared benefits for

delivery and improved performance.

·         Management efficiencies in preparation for any running cost allowance reductions.

Members were advised that under the collaborative arrangement, place based commissioning would continue. This would be important as CCGs further develop integrated working with local authority and provider partners; develop and extend primary care and community services and ensure that services are responsive to local need and reduce the reliance on hospital based care. Dr Findley confirmed that each CCG would retain a strong local clinical voice and leadership whilst also retaining their individual statutory status.

Dr Findley reported that a robust governance framework  ...  view the full minutes text for item 6.

None.

None.

The next meeting date was to be confirmedbut would be around the beginning of February 2019.

      The meeting ended at 3.45 pm.