Agenda item

The Committee received a presentation from the Chief Clinical Officer, Durham Dales, Easington and Sedgefield CCG (DDES CCG) that provided an oversight on NHS Planning and the Developing Commissioning Landscape (for copy see file of Minutes).

The Chief Clinical Officer highlighted the following:-

·         Three Emerging Levels of Commissioning

o   What gets done at each level

o   Place: Durham Integrated Model Overview

o   Teams Around Patients

o   Our Ambition

o   Integrated Care Board Joint Working Arrangements

o   Next Steps and the Future

·         Integrated Care System Update

o   Case for Change

o   ICS Health Strategy Group

o   ICP boundaries

·         5 CCG Collaborative

o   Benefits of collaboration

o   Timetable

o   CNE delivery programmes & enabling strategies

·         NHS long term plan by Autumn 2018

o   Planning

o   Expected Priorities from NHS Plan

o   Clinical Priorities

o   Enablers

o   Southern ICP Priorities

Ms Burton, member of the public, asked if there would be a shift in funding and if monies would be pooled together. She was advised that there were no plans to combine the local authority and CCG funding however they were looking areas in which resources could be best used by working together.  Ms Burton further asked who the ICP was accountable to and if this would be the CCG.  The Chief Clinical Officer agreed that this should be carried out at CCG level but could not confirm as there was no specific strategy.  He reported that it would depend on the size of the ICS as they differed in size throughout the country.

Councillor Bell referred to patient flows across boundaries and asked how one ICP could set its priorities when the others had not when this would affect patients whose geography would determine where they received treatment.

Mr Taylor Gooby expressed concern about accountability and in particular the role of public health who require further funding to enable them to carry out preventative work.  He was surprised that there was no mention of the combined authorities in the presentation as they had sought powers to take on public health.

Moving on, Councillor Smith referred to yet another reorganisation within the NHS management structure and asked if it would reduce management costs.

The Chief Clinical Officer explained that when the PCT moved to CCGs there had been huge cuts in management costs and he believed that there was scope to cut this further with changes being made to systems.  In terms of patient flows he advised that should this cross boundaries then planning would be implemented to work together across the ICPs.  He advised that the money would still follow the patient and financial adjustments would be made to cover this arrangement.

With regards to public health, the Chief Clinical Officer agreed that the combined authorities had a choice of doing this and felt that it would be a mistake not to include these arrangements.  The relationship around prevention for all partners was strong and he fully supported the local authority in asking for the funding not to be cut beyond 2020.

Looking at the ICP priorities, Councillor Darkes was surprised that there was no reference to sepsis and he felt that this should be a priority.  The Chief Clinical Officer agreed and commented that this would be included in the full detailed plan.

Referring to budgets and the pooling of money, Councillor Patterson was concerned about this being ring-fenced or put into one pot as there would be wider implications for the adult social care budget.  Referring to the slide on vulnerable people, she asked if these services were under threat.  The Chief Clinical Officer advised that they would be monitoring the budgets as would cause a real fear should they be ring-fenced.  He added that it was about getting the right money in the right place.  Referring to vulnerable services he reported that there were significant pressures in paediatrics, breast services and he would come back in the New Year to talk about these vulnerable services.

Resolved:

That the presentation be noted.