Agenda item

A draft Integrated Care Board Functions Checklist is also included within the agenda pack for members information

The Committee received a presentation of M Laing, Director of Integrated Community Services, County Durham Care Partnership, which provided an update with regards to the Operating Model for NHS North East and North Cumbria Integrated Care Board (for copy see file of minutes).

Members were given a brief outline of the suggested model framework, the objectives and principles for ICB development which had been agreed by JMEG, and the commissioning arrangements.

In response to a question from Councillor Kay, the Director of Integrated Community Services advised that Sam Allen, former Chief Executive of the Mental Health Trust had joined as Chief Executive of the ICB on 1 February, Sir Liam Donaldson having already been appointed as Chair.  Recruitment to the Board was ongoing and he confirmed that Dr N O’Brien had been appointed as Medical Director.

Councillor Martin advised that one of the dilemmas would be that the model would serve people in the North of the County, however he wondered about the representation for those in the South whose first choice of hospital would not be the University Hospital of North Durham.  Should people prefer to Darlington, he asked how their views would be represented.

The Director of Integrated Community Services confirmed that patients were not confined within the boundaries of County Durham, an example being if someone was treated for a serious cancer, they would be referred to the Freeman or RVI.  TheTrust covered two Local Authority areas and the ICB had to engage with both, including the South.  He referred to the new arrangements as being similar to those of the Health Authority pre-1974, with the only uncertainty being how the regional structure would play out.

Councillor Martin advised that County Durham needed a foot in central and in Teeside and would hope that specialist treatments would continue as they were, rather than be place based.

Councillor Gunn advised that there were issues arising that would need to be resolved and she reminded Members that it was important that their scrutiny role was not jeopardised and that regular presentations on how the ICB was developing were considered.  There were a lot of uncertainties and questions which were difficult to grasp as a lay person and it was crucially important to have regular updates on key issues.

The Chair had noted that it was not enough to be told that in the short-term the change would not be noticeable and agreed that the Committee needed to keep a close eye.  The Director of Integrated Community Services confirmed need to maintain those good relationships between the commissioners and partners under the new arrangements and to ensure colleagues continued to attend and be held accountable by the Committee.

Councillor Gunn was concerned that although residents may not be aware of the difference, changes always made people anxious and there would be a time when they needed to be reassured.  The Director of Integrated Community Services agreed that Members would not receive enquires because residents were concerned about the ICB, but they would receive queries on how to access services or how they could get an appointment with their GP and the point of the changes were to make access and provision of services better for people in County Durham. 

R Gott, Co-optee, noted that the boundaries would make the ICS the largest geographical area in the Country.  She was a member of the Patient Reference Group Sedgefield, who were disappointed that they had not been having necessary meetings.  In January there had been a primary meeting with 50 attendees who found out that only three chairs had given feedback in response to the consultation.

The Director of Integrated Community Services confirmed that feedback had been received with regards to the limited mention of patient representation prior to COVID-19, so patient representation was developing and at CCG level there was strong representation with regards to changing or adapting local services.

R Rooney, North Durham CCG was disappointed with the comments regarding the January meeting as they had been working with PRG’s working over recent months to put together a proposal and second event had been organised.  The CCG were working with practices and wanted to increase the groups as there had been some issues keeping them going.   They were also working with primary care networks and there was a role for a countywide group to feed into ICB.  They were working through the model to put forward a proposal and hoped that the same people would be involved.  They were working with Trusts and the voluntary council to develop principles and co-produce a programme for ongoing engagement, to shape the proposal for County Durham and she would return to present to the Committee.

Councillor Andrews asked a question regarding training at a collaborative level and the Director of Integrated Community Services advised that there would be various roles on the ICB that would ensure clinical deliver and one of the  positions was for a Director of Nursing who would be be responsible for therapies to ensure joint collaboration.

Councillor Deinali advised that if the aim of the new system was to improve accessibility for patients, had consideration been given to accessibility in terms of travel routes and public transport.  The Director of Integrated and Community Services confirmed that accessibility was often considered at individual commissioning levels but many people in the east of the County east preferred to o to Sunderland for treatment.  On  occasions where people needed specialist treatment, transport was not always a concern of a patient and in some areas, such as Weardale, there was no option to have treatment close to home.

The Principal Overview and Scrutiny Officer advised that he was attending a regional committee where a presentation on the ICB would be given and agreed to write to the CEO (designate) at North East and North Cumbria Integrated Care System on behalf of the Committee to express their concerns.

Resolved

That:-

1.    the report and presentation be noted.

2.    The Committee write to the CEO at North East and North Cumbria Integrated Care System to express their concerns in respect of the ICS/ICB developments.