Agenda item

Presentation by Mary Bewley, Durham, Darlington, Teesside, Hambleton, Richmondshire and Whitby STP Communications Lead.

A copy of the narrative and communications pack published on 14 June 2018 in respect of “Integrating and optimising health care services to meet local need and maximise stability” is attached for members information.

The Durham, Darlington, Teesside, Hambleton, Richmondshire and Whitby STP Communications Lead presented a report and gave a presentation on the communications and engagement work stream for NHS organisations in North Cumbria and the North East Region.

Since its creation in 1948, the NHS had evolved and adapted to meet changing

needs and expectations. Patients now had access to a wider range of treatment, using new technology, techniques and medicines, and provided by a changing workforce who have new skills and expertise. Positive outcomes have increased, with more people living longer and healthier lives, often as a result of tailored support for long-term conditions and more successful treatment for serious illness or injury.

Spending less time in hospital is better for patients’ recovery and most

people prefer to be cared for at home if possible. New technologies and ways of

working allow this to happen more easily, which also means a greater need for social care and community health services to be coordinated, and new approaches to prevention and wellbeing, patient centred care and integration of health services across settings.

A number of national and local priorities are influencing how, when and where health care is provided, particularly in relation to services becoming more integrated and coordinated. It is inevitable that some care will need to be provided in a different way, to ensure the best clinical standards are met, that services are fit for future purpose, safe and sustainable.

Senior leaders and doctors from NHS organisations across Cumbria and the North East are working together regionally and locally to:

·         Plan and develop services to meet the needs of local populations from North Yorkshire to the Scottish Borders now and in the future, taking into account how services are currently provided and where they need to change or develop. In particular, where new models of care might need to be introduced to integrate what is provided and ensure patients are seen in the right place, by the right person to meet their needs.

·         Use information held by each organisation to ensure planning and

      development of services is based on patient and population need and

      available skills and resources.

·         Consider how the current and predicted NHS workforce affects the provision of services.

·         Look at services such as tests, scans, x-rays and other diagnostics, and how they could be provided in a more accessible and efficient way.

Integrated care systems (ICSs) are evolving and will lead and plan care for

their specific population and provide coordinated leadership across NHS

organisations. This involves where appropriate taking a ‘do once’ approach to

joint priorities and pieces of work that are common to all organisations in the

area.

Integrated care partnerships (ICPs) are alliances of providers and

commissioners who are collaborating to deliver care. In North Cumbria and

the North East, the proposal is for four ICPs to be in place, to run alongside a

Cumbria and North East ICS, which will take responsibility for overall

coordination in the whole geographical area, by April 2019. Health providers

include hospitals, community services, mental health services, GPs, and

independent and third sector providers. The ICPs will focus initially on

bringing together enough critical mass to sustain vulnerable acute services

within their geography, and the commissioning of non-specialist acute care.

CCGs within these ICP geographies will continue to develop place-based

arrangements for the planning and provision of primary and community care

and health and social care integration, aligned to the overall ICS strategy.

As part of the ensuing discussions, the following comments were made:

·         The time it had taken to get this point was not acceptable. There had been a number of mistakes made in the past and the performance to date had been disappointing. Members were advised that there was the opportunity to share good practice across regions.

·         Concern was raised that the work had taken 3 years and there appeared to be no discernible progress.

·         A Member commented that the consultations had produced a number of concerns from communities around access, travel, the distance patients would have to travel and patient transport. These areas of concern had still not been explored.

·         Not enough detail had been provided. These were major changes and needed to be formally consulted upon.

·         Concern was raised that in some previous consultations, the public were only choosing from the limited options put forward. Care should be taken in the way options were developed.

·         The presentation had been updated each time it had been presented to include feedback that had been provided.

·         A website was being developed that would provide all the necessary information in a single space

·         A Member asked why a project plan wasn’t in place? It would be helpful to know what action had been taken in respect of each milestone.

·         Some examples of other ICPs and ICSs across the country could have been shared.

·         It was important that the 3 acute hospital site model was retained.

·         The clinicians could be invited to attend the DDTHRW STP Joint Health Scrutiny Committee.

·         Every meeting this was discussed was not only costing the NHS money but it was also a cost to Local Government.

·         The NHS had been a wonderful service to the public over the years and people wanted this service to remain.

At the conclusion of the discussions the following action was agreed:

1.    The report be noted; and

2.    The Chief Executives of each of the three NHS Foundation Trusts be invited to a meeting of this committee to discuss in more detail the service changes in the North East ICP area.