Presentation of Director of Integrated Community Services, Durham County Council.
The Board received an update from the Corporate Director of Adult and Health Services and the Director of Integrated Community Services on Health and Social Care Integration progress (for copy see file of minutes).
The Director of Integrated Community Services, Michael Laing explained that the Heath and Care Bill had had its second and third readings in Parliament and recommended changes to partnership arrangements, with the Durham Clinical Commissioning Group (CCG) being abolished by April 2022, and with new arrangements being set up. He added that there was a requirement on the Integrated Care System (ICS) for the North East and North Cumbria to come forward with a proposed constitution, to be approved or otherwise by NHS England by the end of December 2021. He noted that subsequent to the agenda pack being finalised, a letter had been received from Sir Liam Donaldson, Chair of the ICS, noting that those discussions relating to structures were coming to their conclusion and that he was able to submit to NHS England a proposal of what the board would look like at the North East and North Cumbria level. The Director of Integrated Community Services noted that the Board would have representation from four Local Authorities, statutory posts of Medical Director, Chief Executive and Director of Finance, representation from Primary Care and patient groups, such as Healthwatch. He noted that place-based arrangements for County Durham were not yet finalised, with work ongoing, and noted Members had previously stated that there should be as much decision making and finance for County Durham as possible, with Officers working hard in that regard.
The Director of Integrated Community Services explained that the Chief Executive of the ICS Board had been appointed, Sam Allen, and once in post with Sir Liam Donaldson continuing as Chair, the Board would start to take shape with the appointment of non-executive Board Members. He noted that after that, information around place-based arrangements would come forward and added that at the County Durham level, the Health and Wellbeing Board had expressed its desire to integrate services more closely, and Officers continued to work on nine workstreams. He noted focus on discharge from hospital and crisis response, with those workstreams now having come to an end. He reported that, in respect of crisis response the CCG had allocated additional funding to create a crisis response service, within two hours, to avoid hospital admissions from April 2022. He added that how patients were discharged would also change in April in line with national requirements with staff on wards, predominantly Therapists, being able to access Local Authority care and would carry out an assessment on behalf of the Local Authority and the more complicated assessments that often held up a patient would then be carried out in a community setting.
Councillor R Bell noted the number of representatives from Local Authorities would be four and asked whether they would be Officers or Elected Members on the IC Board, and with the North East and North Cumbria encompassing around eight or nine Local Authority areas, he asked how the four Local Authorities would be chosen.
The Director of Integrated Community Services explained guidance from NHS England was clear that Local Authority representatives would be an Executive Officer level, i.e., a Chief Executive or an Executive Director. He noted that in Local Authorities it was usual for Members to have primacy and therefore there would need to be discussions as regards arrangements. He added that in terms of the four representatives it was being proposed to look at the broad areas of Tees Valley, the centre of the area, the north of the area and Cumbria, with those decisions yet to be made and negotiated. Councillor R Bell noted that including Tees Valley would increase the number of potential Local Authorities to around 13 to 15.
The Chair noted that the information was aimed at professionals and asked if it could be made accessible to members of the public. The Director of Integrated Community Services noted that as part of the overall engagement of the ICS, the next step would be for the new Chief Executive and Chair to engage more deeply with communities, an important role for Healthwatch and Primary Care Clinical Directors as representatives of Primary Care and being well connected to their communities. He added that Local Authorities could help with that process and he noted that Sir Liam Donaldson and his team were keen to explain to the public in the North East, once approved, the role of the Board, the differences it would make to health outcomes, and how it would work with partners in the process.
That the presentation be noted.