Agenda item

In attendance for this item were:

NHS Herefordshire and Worcestershire Clinical Commissioning Group:

Simon Trickett, Chief Executive and David Mehaffey, Director of Integrated Care System Development

Worcestershire County Council:

Paula Furnival, Strategic Director for People, Dr Kathryn Cobain, Director of Public Health and Cllr Adrian Hardman, Cabinet Member with Responsibility for Adult Social Care

David Mehaffey, Director of Integrated Care System Development referred to the Agenda report and provided a brief summary of Integrated Care Systems (ICS) and progress in Herefordshire and Worcestershire. The NHS defined integrated care as being about giving people the support they needed, joined up across local councils, the NHS and other partners, and removing the traditional divisions between hospitals and family doctors, physical and mental health, the NHS and council services.

This was an early update, following publication of the White Paper ‘Integration and Innovation: working together to improve health and social care for all’ on 11 February; a lot of information was emerging, and further updates would be provided. The new legislation built on changes in 2012 which created clinical commissioning groups and moved public health function to councils.

The Paper proposed creation of two new bodies, an ICS Group which would be a new body of core NHS organisations and local councils that would subsume the Clinical Commissioning Group (CCG) and an ICS Health and Care Partnership which would bring together wider partners and stakeholders. Together these formed the ICS, which would replace the Sustainability and Transformation Partnership (STP).

The changes would not affect Health and Wellbeing Boards although it would be important to align the new Partnership’s responsibilities as closely as possible. The biggest impact would be for the CCG, which would be worked through over the next few months. A new Unitary Board, to govern the NHS ICS Body would be constituted by a full range of NHS providers, General Practice and Local Authority representatives.

Importantly, a change to competition legislation would reduce the amount of unnecessary procurement when there was an obvious choice of provider for services. Another key difference would be a single system financial target, meaning more collaboration

The new arrangements were due to be implemented from 1 April 2022 and national guidance was awaited, however Worcestershire had a strong base to build on, having already demonstrated its ability to work in partnership. The public may not notice a great deal of change but would see better integrated and digitalised health and social care and a single clinical record system.

The Chairman invited questions and the following main points were raised:

·         The ICS changes could be viewed as yet another change, however the different approach was welcomed by the Committee

·         The CCGs representatives acknowledged debate over recent years about competition within the operating model giving potential for providers including those from abroad to pitch for services with greater potential profit, however ICS legislation was a shift away from this culture, whilst still maintaining flexibility for example to procure help from the independent sector

·         The legislation was very clear to emphasise that all existing provider organisations would remain with the exception of CCGs

·         regarding the fact that areas of deprivation had been hit hard by Covid, the Director of Public Health explained that as part of the ICS development, public health were discussing with the NHS about how to tackle such areas and what was needed

·         From the Council’s perspective, the Strategic Director for People believed the difference brought by the ICS would depend on how it was handled  locally; it felt exciting in terms of the whole statutory system owning and being accountable for the health of Worcestershire’s population including children’s health

·         A member pointed out the importance of recognising the contribution made by the independent sector, which would always be needed.

·         The Cabinet Member with Responsibility for Adult Social Care saw the ICS as a tidying up exercise and reflected what was happening on the ground

·         The Director of ICS Development added that Worcestershire was well placed having already moved to one CCG, with established primary care networks and was already working with Herefordshire.