Agenda item

The Committee received a report of the Joint Head of Integrated Strategic Commissioning, North East and North Cumbria Integrated Care Board and Durham County Council which outlined the draft Joint Forward Plan received from the Integrated Care Board (ICB) on the 4 July 2023 (for copy see file of Minutes).

S Burns, Joint Head of Integrated Strategic Commissioning gave a detailed presentation and explained that the Joint Forward Plan was a national requirement for all ICBs and partner NHS Trusts covering the period 2023/24 –2028/29. The Joint Forward Plan is aligned to system ambitions, building on existing plans and is delivery focussed and demonstrates how ICBs and the NHS Trusts will:

• Arrange and/or provide NHS services to meet the population’s

  physical and mental health needs

• Deliver the NHS Mandate and NHS Long Term Plan in the area

• Meet the legal requirements for ICBs

The Joint Head of Integrated Strategic Commissioning advised that there was an opportunity to provide feedback on the plan and members were therefore encouraged to review the Joint Forward Plan and provide comment on its content. The deadline for feedback was August 2023 with the final publication of the ICB Joint Forward Plan in September 2023. The Joint Head of Integrated Strategic Commissioning advised that an annual update would be issued each March beginning in 2024.

Councillor Stubbs noted the first review of the plan was scheduled for March 2024 and asked how members could monitor the success of the plan and if it was possible to view the report before it was submitted to ensure that members were satisfied with the content. The Joint Head of Integrated Strategic Commissioning explained that in terms of the local element of the plan, this could be brought back to the Committee for members consideration, but she explained that there would be challenges to do the same for the regional element of the plan. 

The Principal Overview and Scrutiny Officer advised that a Joint Regional Committee existed which comprised all 13 Local Authorities in the region and noted the Chair of the AWHOSC was one of the representatives on the committee. He felt that the Joint Regional Committee were best placed to consider the content of the plan from a regional perspective. Councillor Stubbs agreed and stated that a local report would be the priority for local members.

Councillor Jopling emphasised that the plan must address the current issues with dentistry to ensure those requiring treatment could access it, particularly children. The Joint Head of Integrated Strategic Commissioning explained that dental services were previously commissioned by NHS England but were now the responsibility of the ICB. She advised that the plan included a section on dentistry and explained that a group met regularly to consider actions that would help resolve the current problems. The Joint Head of Integrated Strategic Commissioning offered to attend a future meeting of the Committee along with an officer from the dental team to provide members with an update on progress but gave assurance that they were acutely aware of the impact dentistry was having on people in the community and on hospitals and they were doing their best to urgently address this.

R Gott asked if people on certain benefits would meet the criteria for free dentistry. The Joint Head of Integrated Strategic Commissioning advised that this needed to be explored further and agreed to raise this with colleagues in the ICB.

Councillor Crute asked if NHS England had transferred the responsibility for dentistry in its entirety to the ICB or if the role of the ICB was in a monitoring capacity. The Joint Head of Integrated Strategic Commissioning confirmed that the ICB was responsible for commissioning dentistry explaining that they held the funding, were responsible for the staff and for ensuring dentistry provision for the population. Councillor Crute commented that moving this responsibility to local communities was a positive step forward. The Joint Head of Integrated Strategic Commissioning explained that whilst there were challenges for the ICB, there was also an opportunity for her to influence and improve the position with dentistry at a local level. 

G McGee, Healthwatch stressed that a lack of dentistry provision had impacted on several sectors including mental health, personal finances, antibiotic resistance and mouth cancer and asked if the plan considered the long term impacts of this. The Joint Head of Integrated Strategic Commissioning agreed with all points raised and stated that doctors and hospitals had seen an increase in people presenting with dentistry problems. With regards to mouth cancer, she agreed that this had the potential to increase and thanked G McGee for this helpful feedback.

Councillor McKeon asked if it was possible to have a roaming dentist and optometrist, particularly in rural areas as many families had to travel a considerable distance to attend appointments, and in some cases, this impacted on children’s attendance at school. The Joint Head of Integrated Strategic Commissioning agreed to look at this locally but felt that it could be a challenge due to the current absence of dentists.

The Chair asked if all GPs treat dental problems. The Joint Head of Integrated Strategic Commissioning confirmed that whilst there had been an increase in people presenting at GPs with dentistry related problems, she was unsure whether all GPs treated this and agreed to obtain this information from the Local Medical Committee.

In response to a question from Councillor McKeon regarding engagement with schools, the Joint Head of Integrated Strategic Commissioning advised that family hubs performed a strong role in providing people with a range of support under one roof. With regards to mental health in schools, she advised that children’s mental health was currently being reviewed and explained that the Starting Well Partnership had considered the children’s commissioner report and Durham were doing well with investment and waiting times, but currently lacked the plurality of provision. She explained that all services were delivered by TEWV and at present there were not any alternatives to this. The Joint Head of Integrated Strategic Commissioning explained that consideration was being given on how to improve children’s mental health provision and schools were at the heart of this.

Resolved

That the Draft Joint Forward Plan 2023/24 –2028/29 be noted and the comments made by members on the Plan be submitted to the ICB as a formal response from the Committee.